Closing the smoking gap for pregnant women

Paul Hayes

25/10/2017 12:00:00 AM

With as many as 45% of pregnant Aboriginal and Torres Strait Islander women smoking during pregnancy, compared to 13% of non-Indigenous women, it is vital that healthcare professionals are equipped with the best available tools to aid in their smoking cessation.

Assoc Prof Gillian Gould believes a consistent approach to smoking cessation is key
Assoc Prof Gillian Gould believes a consistent approach to smoking cessation is key

GP and general practice researcher Assoc Prof Gillian Gould is leading the large-scale ‘SISTAQUIT in pregnancy’ research project. The project aims to ‘improve the provision of timely, evidence-based smoking cessation support to pregnant women attending Aboriginal medical services (AMS) by training health providers, such as GPs, Aboriginal health workers and midwives in culturally appropriate smoking-cessation care’.
According to Assoc Prof Gould, this is an area in which many health providers have traditionally struggled.
‘You find out somebody is smoking, you can have that initial discussion and give them some advice. But if you don’t follow up, there is no consistency in your messages and it does send a message that perhaps it’s not so important if doctors don’t think it’s important enough to follow up,’ she told newsGP.
Rather than the traditional ‘5As’ method for smoking cessation, SISTAQUIT uses an ‘ABCD’ approach: Ask; Brief advice; Cessation health; Discuss the psychosocial context.
‘The psychosocial context is particularly important for Aboriginal communities, where prevalence is high and quite a few people around the person might be smoking,’ Assoc Prof Gould said.
The pilot stage now complete, having worked with Aboriginal communities in NSW, the project is expanding to as many as 30 Aboriginal medical centres across five states. It is examining the use of a number of digital tools, including webinars and online videos, to provide practitioners and patients with more approaches to smoking cessation.
‘For the mothers, we also have a booklet and within that we have some virtual reality videos that they can watch. They can download a free app on their phone so they can scan pages in the booklet and watch videos, which contain information and motivational messages given by Aboriginal people,’ Assoc Prof Gould said.
‘For example, we’ve got an Aboriginal obstetrician talking about how smoking affects babies, a Torres Strait Islander GP telling the mums how to take each different form of NRT [nicotine replacement therapy], and we have a couple of mothers who are talking about triggers that affected them in pregnancy. More information from peers so women can hear from other Aboriginal mums.
‘If we can show that this approach works and that more women … quit smoking, then the idea is that we would then hopefully scale this up to everywhere in Australia.’
Suggested further reading for GPs

Aboriginal-and-Torres-Strait-Islander antenatal-care smoking

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