Five As Of Tobacco And Nicotine Cessation
1. ASK the patient about all types of tobacco or nicotine use* at the first prenatal visit and follow up with her at subsequent visits. The patient should choose the statement that best describes her tobacco or nicotine use status:
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A. I have never used tobacco or nicotine or have minimal amounts of tobacco or nicotine in my lifetime .
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B. I stopped using tobacco or nicotine before I found out I was pregnant, and I am not using tobacco or nicotine now.
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C. I stopped using tobacco or nicotine after I found out I was pregnant, and I am not using tobacco or nicotine now.
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D. I use some tobacco or nicotine now, but I have cut down on the amount of tobacco or nicotine I use since I found out I was pregnant.
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E. I use tobacco or nicotine regularly now, about the same as before I found out I was pregnant.
If the patient stopped using tobacco or nicotine before or after she found out she was pregnant , reinforce her decision to quit, congratulate her on success in quitting, and encourage her to stay tobacco and nicotine free throughout pregnancy and postpartum. If the patient is still using tobacco or nicotine , document tobacco and nicotine status in her medical record, and proceed to Advise, Assess, Assist, and Arrange.
2. ADVISE the patient who uses tobacco or nicotine to stop by providing advice about quitting with information about the risks of continued tobacco and nicotine use to the woman, fetus, and newborn.
Box 2.
Quitting Smoking While Pregnant: What Works
Nicotine patches, Zyban helped 4 out of 5 women, study says
HealthDay Reporter
WEDNESDAY, July 27, 2016 — Use of nicotine patches or the drug Zyban helps pregnant women quit smoking before and after they give birth, a new study says.
“In public health terms, these results are significant because one in five pregnant women smokes,” said study author Anick Berard, a professor with the Faculty of Pharmacy at the University of Montreal.
“We already know that smoking during pregnancy increases the chances of miscarriage as well as low birth weight, premature birth and birth defects — events that are linked to health problems in children,” Berard said in a university news release.
However, the study authors added that pregnant women or those looking to become pregnant should check with their doctor before taking any medication.
The new study results will give pregnant women evidence-based options to quit smoking, Berard said. They’ll “also give data to health care professionals for them to prescribe the right treatment while evaluating the risks and benefits associated with each pharmacological method,” she said.
The study looked at nearly 1,300 pregnant women in Quebec. It found that 80 percent of pregnant women who used nicotine patches or Zyban were able to stop smoking. Even after they discontinued using the products, 68 percent of those who used nicotine patches and 60 percent of those who used Zyban did not start smoking again during or after pregnancy.
She Knows: How To Quit Smoking While Pregnant
With the January 2014 Surgeon Generals Report on Smoking and Health citing 108,0000 pregnancy and birth-related conditions linked to infant mortality and low birth weight, you may be more determined than ever to kick your nicotine habit to the curb. But, before you go cold turkey, check out these tips on how to quit smoking while pregnant.
Quitting cold turkeyTossing your pack and swearing off cigarettes is an ideal way to avoid the risks of smoking while pregnant, but, the side effects of quitting during pregnancy can range depending on whether youre a light or heavy smoker, advises Dr. Alyssa Dweck, OB/GYN and healthy mama brand medical advisory board member, but can include restlessness, jitteriness, irritability and in severe cases seizures can occur. The good news is that most of these symptoms you experience wont cause harm to your baby-to-be and often are the most difficult in the first two weeks of quitting. The American Pregnancy Association recommends that you increase your chances of success by listing the benefits of quitting, changing your daily habits, building a strong support system and setting a quit date.
When deciding how to quit smoking while pregnant, remember that there is no one-size-fits-all method.
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Alternatives To Help You Quit
Quitting at any point can be extremely difficult, and pregnant women need all the support they can get. Quitting cold turkey has not shown to negatively affect your baby, and studies show a higher success rate of pregnant women. However, cravings and withdrawal may build a false belief that you are unable to quit.
Dont give up trying on giving up. Concentrate on the benefits it will have for you and your baby. Many women have gone through this experience before you and have been successful. You need to call on your determination, mindset, persistence and social support through the worst of it to help you with this difficult task. There are many options currently available, which can make this frustrating mission much easier to achieve.
Q: How Much Does Smoking Impact Mens Fertility
Dr. Vij: Theres more inflammation in the semen of men who smoke. This can weaken the sperm and make pregnancy more difficult to achieve.
Cigarettes contain toxic levels of carcinogens and mutagenic substances. They also contain heavy metals , which are shown to be the primary agents of sperm damage.
Studies show that smoking can lead to DNA damage in sperm. Some evidence shows that men with elevated sperm with DNA damage may have reduced fertility and higher miscarriage rates.
In addition, smoking is a risk factor for erectile dysfunction , which can make getting pregnant a challenge. According to the Journal of Andrology, men are about twice as likely to have ED if they smoke. After adjusting for other risk factors, men who smoke more than 20 cigarettes a day are 1.5 times more likely to have ED than men who dont.
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When The Urge To Smoke Strikes Remember The 4ds
- Delay for at least five minutes, the urge will pass
- Deep breathe slowly and deeply
- Do something else to keep your hands busy
- Drink water to take time out, sip slowly.
For more information: talk to your doctor, pharmacist or Quitline.
Please note, this information is not intended to replace consumer medicines information or health professional advice. If you would like to provide feedback, please contact .
You can help us improve by letting us know when you think we could do better and when we got it right. To help us improve, please go to Complaints, Compliments and Feedback.
How Does Smoking Affect Fertility
Smoking can cause fertility problems for you or your partner. Women who smoke have more trouble getting pregnant than women who dont smoke. In men, smoking can damage sperm and contribute to impotence . Both problems can make it harder for a man to father a baby when he and his partner are ready.3, 4
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Smoking During Pregnancy And Your Babys Health
A huge quantity of scientifically proven studies based on clinical research outline the damaging and potentially life-threatening effects of cigarette smoke during pregnancy. Smoking has been pinpointed as one of the leading avoidable behaviours that are most damaging to a developing baby.
Not to mention the added long term risk that tobacco smoke can have on your child as they grow older, such as a higher chance of developing ADHD and suffering from Asthma in their adulthood.
How Will I Feel When I Quit Smoking During Pregnancy
The benefits of not smoking start within days of quitting. After you quit, you and your baby’s heartbeat will return to normal, and your baby will be less likely to develop breathing problems.
You may have symptoms of withdrawal because your body is used to nicotine, the addictive substance in cigarettes. You may crave cigarettes, be irritable, feel very hungry, cough often, get headaches, or have difficulty concentrating. The withdrawal symptoms are only temporary. They are strongest when you first quit but will go away within 10-14 days. When withdrawal symptoms occur, stay in control. Think about your reasons for quitting. Remind yourself that these are signs that your body is healing and getting used to being without cigarettes. Remember that withdrawal symptoms are easier to treat than the major diseases that smoking can cause.
Continued
Even after the withdrawal is over, expect periodic urges to smoke. However, these cravings are generally short-lived and will go away whether you smoke or not. Don’t smoke!
If you relapse and smoke again do not lose hope. Of the people who quit, 75% relapse. Most smokers quit three times before they are successful. If you relapse, don’t give up! Plan ahead and think about what you will do next time you get the urge to smoke.
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Q: What About The Impact Of Secondhand Smoke
Dr. Austin: Exposure to secondhand smoke in the household is bad for female fertility. Even if a person doesnt smoke in the home, smoke can still be present on the hair and clothing of the smoker and harm other members of the household.
Once a woman gets pregnant, secondhand smoke can increase the risk of miscarriage, low birth weight and learning disabilities. Theres abundant evidence that shows that smoke exposure to a newborn baby can lead to respiratory infections, asthma and sudden infant death syndrome.
Smoking During Early Pregnancy
Smoking during early pregnancy is extremely difficult to avoid if the mother is unaware that she is pregnant. When a pregnancy is planned it is best to quit smoking in advance of conception but in the case of unplanned pregnancies it can be quite a shock and extremely worrying for the expectant mother who smokes.
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What About After My Baby Is Born
Quitting smoking is just as important after your baby is born. Quitting before or during pregnancy can improve the health of your baby even as he or she grows older. If you stay quit, your newborn will be at lower risk for chest colds, coughs, ear infections and asthma problems caused by exposure to secondhand smoke. Youll also lower your babys risk for sudden infant death syndrome.
In addition, quitting smoking reduces the chances that your baby will be overweight or obese as he or she grows up, have behavioral disorders or attention deficit disorder later in life or develop high blood pressure.
Why Is Quitting Good For My Baby
Once you stop smoking, all kinds of good things happen for your baby. Quitting increases the amount of oxygen your baby will get, helping the baby develop and grow properly, and increases the chances your babys lungs will work well. Quitting also lowers the risk of several major complications, including premature birth , low birth weight and miscarriage or stillbirth.
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What Do I Need To Know
Smoking during pregnancy harms both you and your baby. It can cause complications during your pregnancy and affect your babys development.
Quitting smoking before or during your pregnancy, or even after the baby is born, is the best way to protect your baby and yourself. Both you and your baby will benefit straight away.
Can Smoking Cause Miscarriage
Smoking is harmful in many ways and losing a pregnancy is a terrible thing. In the first three months of pregnancy the risk of miscarriage is highest with the majority of experts agreeing that most of these miscarriages cannot be prevented and are due to genetic abnormalities. However, certain lifestyle choices do increase the risk of miscarriage and there is scientific research that it is twice as likely to occur for those who smoked heavily than for non-smokers1.
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Answers To 8 Common Questions About Smoking And Pregnancy
2017 min
Quitting tobacco is one of the best things that expectant mothers can do for their health and the health of their babies.
What makes quitting so important at this stage? We turned to the experts behind BecomeAnEX®, a digital quit-smoking program by Truth Initiative® and developed in collaboration with Mayo Clinic, for answers to eight common questions about smoking and pregnancy.
Passive Smoking And Pregnancy
Even if you dont smoke, people smoking around you secondhand smoke or passive smoking can seriously affect you and your babys health. There are many risks to unborn babies exposed to passive smoking, some of which are:
- stillbirth
- poor health and growth of baby
- low birth weight.
To keep yourself and your baby safe, ask smokers to smoke outside the house or car and try to remain away from them while they are smoking .
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Explore Quit Smoking Tools
There are many ways to quit smoking you dont have to quit cold turkey. Below are free, no-judgment resources that will help you quit.
- Try SmokefreeMOM. This text message program gives 24/7 support to pregnant women. Enter your childs due date to receive customized messages that match where you are in your pregnancy. Then, choose your goal of the program: to quit smoking or receive messages on smoking and health. You have the option to receive support even if youre not yet ready to quit permanently. or text MOM to 222888 to join now.
- . Women who have quit, or are trying to quit, offer one another advice and inspiration.
- Make your phone your quit buddy. Download quitSTART or QuitGuide, Smokefrees free smartphone apps. Track your cravings by time and location to help you see patterns so you can stay in control. They also have ways to see your progress and fun distractions to keep you from having a slip.
- Speak with a quit smoking counselor. Call , or log on to LiveHelp, an online chat service. A trained specialist will give you support and quit smoking information.
Tip: It might take some time to find the quit method that works best for you. If one isnt working, try something new. Each time you try is a step closer to a smokefree life.
How Can A Premature Birth Harm Your Baby
If you smoke during pregnancy, you are more likely to give birth too early. A baby born 3 weeks or more before your due date is premature.5 Babies born too early miss important growth that happens in the womb during the final weeks and months of pregnancy.6
The earlier a baby is born, the greater the chances for serious health problems or death. Premature babies can have:6,7,8
- Low birth weight
- Breathing problems that last into childhood
- Cerebral palsy
- Developmental delays
- Problems with hearing or eyesight
Premature babies may need to stay at the hospital for days, weeks, or even months.5
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Q: What Are The Biggest Challenges Involved With Quitting Smoking While Coping With Infertility
Dr. Vij: Infertility is an incredibly stressful situation for couples to deal with, and stress is a huge driver for smoking. So its important to find other ways to cope with stress that dont harm reproductive health.
Doctors can provide assistance in helping men and women quit smoking. There are several medications that have proven to be effective in helping people quit, including bupropion and varenicline . To get started, schedule an appointment with your doctor and ask for help.
Stopping Smoking At Any Time During Your Pregnancy Will Give Your Baby A Healthier Start In Life
Expecting a baby usually increases the pressure to stop smoking. We get that, and were here to help. We want to let you know that theres a lot of support for you.
Quitline counsellors are trained to help you during your pregnancy. Your doctor, pharmacist or maternity care provider can also offer stop smoking information and support.
Quitline can support you right through to the birth, and in the weeks after your baby is born. Call 13 7848 or request a Quitline .
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Can I Use A Nicotine Replacement During Pregnancy
Nicotine gum and patches release nicotine into the bloodstream of the smoker who is trying to quit. Although these products can reduce withdrawal symptoms and decrease cravings in smokers who are trying to quit, the safety of these products hasn’t been adequately evaluated in pregnant women.
The American College of Obstetrics and Gynecology recommends that nicotine gum and patches be considered in pregnant women only after other nondrug treatments, like counseling, have failed and if the increased likelihood of quitting smoking, with its potential benefits, outweighs the unknown risk of nicotine replacement and potential smoking.
How An App Can Help You Quit Smoking
Using Quit, an app that makes use of a custom made menu, you can gain the upper hand when you are craving a cigarette. One of the best aspects about using hypnosis to stop smoking is it can be used safely in your own home, risk free. Or anywhere you can find a space to listen to the calming voice of a certified hypnotherapist.
It includes a useful tracker, which can tell you how many cigarettes you have managed to avoid smoking. Not to mention, it also lets you know how much money you have saved as a result of not smoking. With this app, you can start thinking about how you can financially improve your babys future, and your own health.
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