As “Physician to the United States,” the US surgeon general speaks with a strong voice about a variety of health concerns, with a focus on prevention and wellness. January 2014 will mark the 50th anniversary of the first surgeon general’s report to conclude that smoking cigarettes causes lung cancer. Five decades later, 43 million American adults continue to smoke, and cigarette smoking kills an estimated 440,000 Americans each year.
I was happy to represent ACOG last week, standing with Surgeon General Regina Benjamin, MD, the Centers for Disease Control and Prevention, and our colleagues at other physician organizations to launch “Talk With Your Doctor,” a campaign to encourage patients to come to us, their physicians, and learn how to succeed with smoking cessation. As ob-gyns, we need a strong voice here. We see the short- and long-term impact of smoking on women and on their families. It is imperative that we assist all of our patients in their efforts to quit smoking, especially our pregnant patients.
A woman who stops smoking at the start of a pregnancy can reduce her risk of pregnancy complications. We ob-gyns need to help our pregnant patients understand that smoking cessation brings immediate results and immediate successes.
The most important step is to ask, and then to respond. We need to treat smoking the same way we have treated vital signs—as a measure that we routinely screen for and assess—and be prepared to support patients who are ready to kick the habit. Surveys have shown that most of us ASK about smoking, yet only one-third provide assistance or a program. Cessation programs are most effective in helping people quit smoking.
When we see our patients, we all need to remember the FIVE A’s:
• Ask about tobacco use.
• Advise to quit.
• Assess willingness to make a quit attempt.
• Assist in quit attempt.
• Arrange follow-up.
ACOG has developed a smoking cessation during pregnancy guide for clinicians to help pregnant patients kick the habit. Check out this helpful resource and be ready when a patient says “I was told to ‘Talk With My Doctor.’”
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