title: Screening practices and attitudes of obstetricians-gynecologists toward new and emerging tobacco products.
abstract: OBJECTIVE
  We examined screening practices and attitudes of obstetricians-gynecologists toward the use of noncombustible tobacco products (chewing tobacco, snuff/snus, electronic cigarettes, and dissolvables) during pregnancy.
  
  
  METHODS
  The authors mailed a survey in 2012 to 1024 members of the American College of Obstetricians and Gynecologists, including Collaborative Ambulatory Research Network (CARN) and non-CARN members. Stratified random selection was used to generate CARN and non-CARN samples.
  
  
  RESULTS
  Response rates were 52% and 31% for CARN and non-CARN members, respectively. Of 252 total eligible respondents (those currently providing obstetrics care) 53% reported screening pregnant women at intake for noncombustible tobacco product use all or some of the time, and 40% reported none of the time. Respondents who reported that noncombustible products have adverse health effects during pregnancy, but are safer than cigarettes, ranged from 20.2% (dissolvables) to 29% (electronic cigarettes) and that the health effects are the same as those of cigarettes from 13.5% (electronic cigarettes) to 53.6% (chewing tobacco). Approximately 14% reported that electronic cigarettes have no adverse health effects; <1% reported no health effects for the remaining products. Two-thirds of the respondents wanted to know more about the potential health effects of noncombustible tobacco products; only 5% believed themselves to be fully informed.
  
  
  CONCLUSIONS
  A large proportion of obstetrician-gynecologists reported never or inconsistently screening their pregnant patients for the use of noncombustible tobacco products. Responses regarding the harms of these products relative to cigarettes were mixed and most respondents wanted more information. Development and dissemination of guidance for providers is needed to improve decision-making regarding noncombustible tobacco products.
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: lbe9@cdc.gov.
authors.forename: Lucinda Jane
authors.initials: LJ
authors.lastname: England
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC.
authors.forename: Britta Louise
authors.initials: BL
authors.lastname: Anderson
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Van Thi Ky
authors.initials: VT
authors.lastname: Tong
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Mahoney
authors.affiliation: Chestnut Health Systems, Normal, IL.
authors.forename: Victoria Hope
authors.initials: VH
authors.lastname: Coleman-Cowger
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Paul
authors.initials: P
authors.lastname: Melstrom
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC.
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
mesh_terms: D001291:Attitude of Health Personnel; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D006176:Gynecology; D006801:Humans; D008297:Male; D008403:Mass Screening; D009774:Obstetrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D016540:Smoking Cessation; D014030:Tobacco, Smokeless
keywords: electronic cigarette; obstetrician-gynecologist; pregnancy; smokeless tobacco