title: Provision and effect of quit-smoking counselling by primary care midwives.
abstract: OBJECTIVE
  we aimed to evaluate the provision of quit-smoking counselling by midwives in the Netherlands and its effect on smoking behaviour and birth weight.
  
  
  METHODS
  quasi-experimental study in which we collected information from pregnant women who smoke throughout their pregnancy by extracting data from electronic patient files.
  
  
  METHODS
  primary care midwifery practices.
  
  
  METHODS
  851 pregnant women who smoke, treated between 2011 and 2014.
  
  
  METHODS
  quit-smoking counselling.
  
  
  RESULTS
  the midwives decided to provide quit-smoking counselling to the participant or not. Non-counselled women were used as the control group. The primary outcome parameter was quit smoking, defined as 'quit smoking by end of pregnancy'. At intake, 67% of the women smoked 1-9 cigarettes a day, 23% smoked 10-20 cigarettes a day and 4% more than 20 cigarettes a day. The midwives began counselling with 42% of the participants, but seldom completed all the counselling steps. The average quit rate was 10% and average birth weight of the babies was 3200g. We found no difference in quit rate or birth weight between counselled women and those who were not. However, the data suggested that counselling is more effective when more steps of counselling are completed.
  
  
  CONCLUSIONS
  no effect was found of quit-smoking counselling on quit-smoking rate or birth weight. Possibly, counselling is effective when provided extensively throughout pregnancy.
  
  
  CONCLUSIONS
  our study shows that provision of counselling can be improved.
authors.affiliation: Public Health Department, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: s.oudewesselink@erasmusmc.nl.
authors.forename: Sandra F
authors.initials: SF
authors.lastname: Oude Wesselink
authors.affiliation: Public Health Department, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: h.lingsma@erasmusmc.nl.
authors.forename: Hester F
authors.initials: HF
authors.lastname: Lingsma
authors.affiliation: Dutch Health Care Inspectorate, P.O. Box 2680, 3500GR Utrecht, The Netherlands; Institute of Health Policy & Management, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Electronic address: pb.robben@igz.nl.
authors.forename: Paul B M
authors.initials: PB
authors.lastname: Robben
authors.affiliation: Public Health Department, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: j.mackenbach@erasmusmc.nl.
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D003376:Counseling / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008880:Midwifery / Q000458:organization & administration*; D009035:Mothers / Q000193:education* / Q000523:psychology; D015404:Nursing Methodology Research; D011247:Pregnancy; D011248:Pregnancy Complications / Q000451:nursing* / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Birth weight; Midwives; Pregnancy; Primary care; Quit-smoking counselling