Helping Pregnant Women Cope With Smoking Cessation

M. Elena Mendoza, John F. Chaves, PhD

Disclosures

Topics in Advanced Practice Nursing eJournal. 2003;3(4) 

In This Article

Abstract and Introduction

Smoking is associated with well-documented threats to health and well being. Pregnancy presents an unusually important time to initiate smoking cessation strategies because of the motivation of the mother to protect her fetus and the opportunity to provide a significant health benefit to both the fetus and the mother at the same time. The emotional support and encouragement provided by an empathic nurse, coupled with specific strategies to strengthen motivation and help patients cope with the cessation process, can contribute to a successful outcome.

According to the Centers for Disease Control and Prevention,[1] smoking contributes to more than 450,000 deaths per year and is the primary cause of preventable morbidity, mortality, and health expense in the United States. During 1995-1999, smoking caused approximately $157 billion in annual health-related economic losses.[2] During this period of time, smoking caused an annual average of 264,087 deaths among men and 178,311 deaths among women in the United States, most of them attributed to lung cancer (124,813), ischemic heart disease (81,976), and chronic airways obstruction (64,735).[2] Total annual smoking-attributable mortality estimates include the deaths of 589 males and 377 females by residential fire during 1994-1998,[3] and the additional deaths of 15,517 males and 22,536 females from lung cancer and heart disease attributable to exposure to secondhand smoke.[4]

This year alone, lung cancer will kill nearly 68,000 US women. That is 1 in every 4 cancer deaths among women, and about 27,000 more deaths than from breast cancer (41,000). In 1999, approximately 165,000 women died prematurely from smoking-related diseases, like cancer and heart disease. Women also face unique health effects from smoking such as problems related to pregnancy.[5] In the United States, of the 4 million women who deliver infants each year, approximately 0.8-1 million smoke during their pregnancies.[6] This fact resulted in the death of 599 male and 408 female infants annually during 1995-1999.[2]

Pregnant women may be uniquely motivated toward smoking cessation due to its effect on the fetus. Both pharmaceutical and behavioral strategies for smoking cessation are reviewed here. A case example is given to illustrate behavioral intervention with a pregnant woman.

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