title: Perceptions and use of smoking cessation in nurse-midwives' practice.
abstract: The objective of this study was to examine Ohio nurse-midwives' perceptions and use of a smoking cessation protocol in assisting pregnant smokers. The total population of licensed Ohio nurse-midwives (n = 300) was surveyed by using a cross-sectional survey design. Only 4 of 10 items that assessed a nationally recommended method of promoting smoking cessation were done by 50% or more of respondents. Few nurse-midwives identified barriers to counseling pregnant patients who smoked, but the most common were lack of time (14%) and not knowing where to send pregnant smokers for treatment (14%). Most respondents believed that nicotine replacement therapy (NRT) would be most likely to reduce the number of pregnant smokers (74%), yet few (26%) were confident in their ability to prescribe/recommend nicotine replacement therapy. Respondents more likely to use 5 A's can be characterized as the following: had higher efficacy expectations in their ability to communicate issues about the 5 A's and had higher outcome expectations regarding the effects of using the 5 A's. Nurse-midwife training programs and continuing education needs to include current research in nicotine replacement therapy use in pregnant patients and 5 A's techniques to assist pregnant smokers in quitting.
authors.affiliation: Division of Public Health, Department of Public Health and Rehabilitative Services, University of Toledo, Toledo, OH 43606, USA. jprice@utnet.utoledo.edu
authors.forename: James H
authors.initials: JH
authors.lastname: Price
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Jordan
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Dake
mesh_terms: D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000706:statistics & numerical data*; D009820:Ohio; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000451:nursing* / Q000517:prevention & control*; D020377:Self Efficacy; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*