title: Smoking cessation during pregnancy and postpartum: practice patterns among obstetrician-gynecologists.
abstract: OBJECTIVE
  To assess current obstetrician-gynecologist (ob-gyn) practice patterns related to the management of and barriers to smoking cessation during pregnancy and postpartum.
  
  
  METHODS
  A smoking cessation questionnaire was mailed to 1024 American College of Obstetricians and Gynecologists Fellows in 2012. χ(2) analyses were used to assess for categorical differences between groups, Pearson r was used to conduct correlational analysis, and analysis of variance was used to assess for mean differences between groups.
  
  
  RESULTS
  The analyses included 252 practicing ob-gyns who see pregnant patients who returned a completed survey. Ob-gyns estimated that 23% of their patients smoke before pregnancy, 18% smoke during first trimester, 12% during second trimester, and 11% during third trimester. They approximated that 32% quit during pregnancy, but 50% return to smoking postpartum. A large majority of ob-gyns feel that it is important for pregnant and postpartum women to quit smoking, and report asking all pregnant patients about tobacco use at the initial prenatal visit. Fewer ob-gyns follow-up on tobacco use at subsequent visits when the patient has admitted to use at a prior visit. The primary barrier to intervention was reported as time limitations, though other barriers were noted that may be addressable through the provision of additional training and resources offered to physicians.
  
  
  CONCLUSIONS
  Compared with findings from a similar study conducted in 1998, physicians are less likely to adhere to the 5 As smoking cessation guideline at present. As we know that brief intervention is effective, it is imperative that we work toward addressing practice gaps and providing additional resources to address the important public health issue of smoking during pregnancy and postpartum.
authors: From Chestnut Health Systems (VHCC), Normal, IL; and American College of Obstetricians and Gynecologists (BLA, JM, JS), Washington, DC.
authors: Victoria H
authors: VH
authors: Coleman-Cowger
authors: Britta L
authors: BL
authors: Anderson
authors: Jeanne
authors: J
authors: Mahoney
authors: Jay
authors: J
authors: Schulkin
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D011181:Postnatal Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires