1. State of Evidence | 2. Better Practices Approaches

In Expecting to Quit, the wider literature in women’s health, women-centered care, and teenaged girls and women’s smoking and substance use, was consulted to frame the results of the intervention evidence presented above, and inform the following better practices approaches:

Tailoring

• All pregnant women should be assessed for smoking.
• Spontaneous quitters should be monitored and supported during pregnancy and postpartum to prevent relapse.
• Smokers who cannot quit using behavioural interventions should be encouraged to try nicotine replacement therapies.

Women Centred Care

• Focus on the woman’s own health as a motivator for quitting.
• This encourages internal motivation and post pregnancy health and decreases relapse once the baby is born.

Stigma Reduction

• Acknowledge the negative social responses to pregnant women smoking and assist in dealing with stigma.
• Recognize that smoking is an addiction, and although many pregnant smokers may want to quit, it is difficult for them to do so.

Relapse Prevention

• Identify women who have quit during pregnancy and support them throughout pregnancy and after their babies are born.
• Despite being smoke-free for a long period, some women may be at an earlier stage of change.
• Recognize postpartum physical, social and emotional changes that result in increased cravings and pressures.

Harm Reduction

• Encourage women who cannot quit to reduce the number of cigarettes they smoke.
• Encourage women to abstain for brief periods of time, and around delivery.
• Encourage women to decrease their exposure to environmental tobacco smoke.

Partner and Family Support

• Examine the patterns of smoking by partner, friends and family.
• Address partner smoking, but in a de-linked fashion-i.e. separately from the woman.
• Recognize differences and power dynamics between partners.

Integration of Social Issues

• Recognize that in the context of many women’s lives, smoking is a secondary issue—to poverty, violence, lone motherhood and other factors.
• Offer free cessation aids and referrals to community support organizations in the area.