+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Opportunities Missed: A Cross-Sectional Survey of the Provision of Smoking Cessation Care to Pregnant Women by Australian General Practitioners and Obstetricians



Opportunities Missed: A Cross-Sectional Survey of the Provision of Smoking Cessation Care to Pregnant Women by Australian General Practitioners and Obstetricians



Nicotine and Tobacco Research 19(5): 636-641



Similar to other high-income countries, smoking rates in pregnancy can be high in specific vulnerable groups in Australia. Several clinical guidelines exist, including the 5A's (Ask, Advice, Assess, Assist, and Arrange), ABCD (Ask, Brief advice, Cessation, and Discuss), and AAR (Ask, Advice, and Refer). There is lack of data on provision of smoking cessation care (SCC) of Australian General Practitioners (GPs) and Obstetricians. A cross-sectional survey explored the provision of SCC, barriers and enablers using the Theoretical Domains Framework, and the associations between them. Two samples were invited: (1) GPs and Obstetricians from a college database (n = 5571); (2) GPs from a special interest group for Indigenous health (n = 500). Dimension reduction for the Theoretical Domains Framework was achieved with factor analysis. Logistic regression was carried out for performing all the 5A's and the AAR. Performing all of the 5A's, ABCD, and AAR "often and always" was reported by 19.9%, 15.6%, and 49.2% respectively. "Internal influences" (such as confidence in counselling) were associated with higher performance of the 5A's (Adjusted OR 2.69 (95% CI 1.5, 4.8), p < .001), whereas "External influences" (such as workplace routine) were associated with higher performance of AAR (Adjusted OR 1.7 (95% CI 1, 2.8), p = .035). Performance in providing SCC to pregnant women is low among Australian GPs and Obstetricians. Training clinicians should focus on improving internal influences such as confidence and optimism. The AAR may be easier to implement, and interventions at the service level should focus on ensuring easy, effective, and acceptable referral mechanisms are in place. Improving provision of the 5A's approach should focus on the individual level, including better training for GPs and Obstetricians, designed to improve specific "internal" barriers such as confidence in counselling and optimism. The AAR may be easier to implement in view of the higher overall performance of this approach. Interventions on a more systemic level need to ensure easy, effective, and acceptable referral mechanisms are in place. More research is needed specifically on the acceptability of the Quitline for pregnant women, both Indigenous and non-Indigenous.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 060047011

Download citation: RISBibTeXText

PMID: 28403469

DOI: 10.1093/ntr/ntw331


Related references

Smoking cessation care provision in Australian alcohol and other drug treatment services: A cross-sectional survey of staff self-reported practices. Journal of Substance Abuse Treatment 77: 101-106, 2017

Clinician factors associated with prescribing nicotine replacement therapy in pregnancy: A cross-sectional survey of Australian obstetricians and general practitioners. Australian and new Zealand Journal of Obstetrics and Gynaecology 58(3): 366-370, 2018

Supporting pregnant women to quit smoking: postal survey of New Zealand general practitioners and midwives' smoking cessation knowledge and practices. New Zealand Medical Journal 121(1270): 53-65, 2008

Provision of smoking cessation support for pregnant women in England: results from an online survey of NHS Stop Smoking Services for Pregnant Women. Bmc Health Services Research 14: 107, 2014

Effects of occupational violence on Australian general practitioners' provision of home visits and after-hours care: a cross-sectional study. Journal of Evaluation in Clinical Practice 14(2): 336-342, 2008

Management of asthma in pregnant women by general practitioners: a cross sectional survey. Bmc Family Practice 12: 121, 2011

Missed opportunities: a qualitative exploration of the experiences of smoking cessation interventions among socially disadvantaged pregnant women. Women and Birth 28(1): 8, 2015

Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey. International Journal of Environmental Research and Public Health 14(12):, 2017

Missed opportunities for tobacco use screening and brief cessation advice in South African primary health care: a cross-sectional study. Bmc Family Practice 11: 94, 2010

Use of action planning to increase provision of smoking cessation care by general practitioners: role of plan specificity and enactment. Implementation Science 9: 180, 2014

Provision of antenatal smoking cessation support: a survey with pregnant Aboriginal and Torres Strait Islander women. Nicotine and Tobacco Research 17(6): 746-749, 2015

Medication adherence among pregnant women with hypothyroidism-missed opportunities to improve reproductive health? A cross-sectional, web-based study. Patient Education and Counseling 99(10): 1699-1707, 2016

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey. Bmc Public Health 12: 165, 2012

Validation of the "SmoCess-GP" instrument - a short patient questionnaire for assessing the smoking cessation activities of general practitioners: a cross-sectional study. Bmc Family Practice 11: 9, 2010

Addressing smoking among people living with HIV: a cross-sectional survey of Australian HIV health practitioners' practices and attitudes. Aids Care 31(4): 436-442, 2019