Have We Really “Come a Long Way, Baby?”

Fifty years ago, Surgeon General Luther Terry submitted a landmark report linking smoking to illness and death and said the government should do something to curb tobacco use. At the time, a third of American women were regular smokers. Today, the rate is down to 16%.

There was a time when smoking was portrayed as glamorous. Now we know that smoking negatively impacts every body organ and is the leading cause of premature death for adults. Women smokers have greater risks of reproductive health problems, many forms of gynecological and other cancers, heart disease, chronic obstructive lung disease, and osteoporosis. Quitting smoking is one of the most important things a pregnant woman can do for her and her baby’s health.

There are a number of effective methods to help our patients stop smoking, and we should be as familiar with them as we are with methods of birth control. These include using the 5 As (Ask, Assess, Advise, Assist, and Arrange follow-up), referring patients to the smokers’ quit line (1-800-Quit Now), and prescribing therapy to ease nicotine withdrawal. Nicotine replacement and medication improve the chances for sustained smoking cessation in non-pregnant women by 20–36%.

Of course, ACOG has several great tools and resources to help ob-gyns and their practices address tobacco use.

So, yes, we have come a long way toward reducing women’s smoking, but we can’t stop now. We need to continue making it a priority to counsel our patients about the health hazards of smoking and offer them help in quitting. And we can have an impact in our communities by promoting hefty taxation on tobacco products and supporting clean air legislation.

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Smoking Cessation Front and Center with “Talk With Your Doctor” Initiative

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.’”

Dr. Conry and "Talk With Your Doctor" Panel

Dr. Conry and “Talk With Your Doctor” Panel

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Today is the Great American Smokeout

Today, November 17th, is the Great American Smokeout—a perfect time for physicians to become reenergized and recommitted to helping our patients quit.

According to the American Cancer Society, 75% of women say they want to stop smoking. However, with one in five Americans still lighting up, the reality is clear: quitting smoking is hard. The average smoker will make several quit attempts before kicking the habit for good. This can be frustrating for the smoker and the physician. But, as ob-gyns, we must remain sensitive and engaged with our patients who attempt to quit smoking.

Pregnant smokers increase their risk of preterm birth, placental abruption, low birth weight, asthma, and SIDS. But quitting early in pregnancy greatly minimizes these risks.

We should make it our business to follow up with patients who have expressed interest in quitting and help them find resources that can improve their chances of success, including medication, support groups, and help lines (such as 800-QUIT-NOW). Studies show that people who use telephone counseling are twice as likely to quit smoking as those who don’t get use this type of intervention. There is even a new smoking cessation app for smart phones to help smokers stay tobacco-free.  

Let’s pledge to walk with them along the path to healthier and longer lives.