Smoking Patterns and Receipt of Cessation Services Among Pregnant Women in Argentina and Uruguay

BERRUETA, MABEL; MORELLO, PAOLA; ALEMÁN, ALICIA; TONG, VAN T.; JOHNSON, CAROLYN; DIETZ, PATRICIA M.; FARR, SHERRY L.; MAZZONI, AGUSTINA; COLOMAR, MERCEDES; CIGANDA, ALVARO; LLAMBI, LAURA; BECÚ, ANA; GIBBONS, LUZ; SMITH, RUBEN A.; BUEKENS, PIERRE; BELIZÁN, JOSE M.; ALTHABE, FERNANDO

NICOTINE AND TOBACCO RESEARCH

OXFORD UNIV PRESS

Año: 2016 vol. 18 p. 1116 - 1125

1462-2203

Introduction: The 5A´s (Ask, Advise, Assess, Assist, and Arrange) strategy, a best-practice approach for cessation counseling, has been widely implemented in high-income countries for pregnant women; however, no studies have evaluated implementation in middle-income countries. The study objectives were to assess smoking patterns and receipt of 5A´s among pregnant women in Buenos Aires, Argentina and Montevideo, Uruguay. Methods: Data were collected through administered questionnaires to women at delivery hospitalizations during October 2011-May 2012. Eligible women attended one of 12 maternity hospitals or 21 associated prenatal care clinics. The questionnaire included demographic data, tobacco use/cessation behaviors, and receipt of the 5A´s. Self-reported cessation was verified with saliva cotinine. Results: Overall, of 3400 pregnant women, 32.8% smoked at the beginning of pregnancy; 11.9% quit upon learning they were pregnant or later during pregnancy, and 20.9% smoked throughout pregnancy. Smoking prevalence varied by country with 16.1% and 26.7% who smoked throughout pregnancy in Argentina and Uruguay, respectively. Among pregnant smokers in Argentina, 23.8% reported that a provider asked them about smoking at more than one prenatal care visit; 18.5% were advised to quit; 5.3% were assessed for readiness to quit, 4.7% were provided assistance, and 0.7% reported follow-up was arranged. In Uruguay, those percentages were 36.3%, 27.9%, 5.4%, 5.6%, and 0.2%, respectively. Conclusions: Approximately, one in six pregnant women smoked throughout pregnancy in Buenos Aires and one in four in Montevideo. However, a low percentage of smokers received any cessation assistance in both countries. Healthcare providers are not fully implementing the recommended 5A´s intervention to help pregnant women quit smoking.