A pragmatic guide for smoking cessation counselling and the initiation of nicotine replacement therapy for pregnant Aboriginal and Torres Strait Islander smokers

Gould, Gillian S., Bittoun, Renee, and Clarke, Marilyn J. (2015) A pragmatic guide for smoking cessation counselling and the initiation of nicotine replacement therapy for pregnant Aboriginal and Torres Strait Islander smokers. Journal of Smoking Cessation, 10 (2). pp. 96-105.

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Abstract

Smoking prevalence of pregnant Aboriginal and Torres Strait Islander women is quadruple that of pregnant women in the Australian population, and is associated with significant adverse outcomes in pregnancy. While cessation is a priority, there is as yet little evidence for effective interventions. This paper provides a pragmatic approach to addressing the complexities of smoking in pregnant Aboriginal and Torres Strait Islander peoples and informs clinicians about the initiation of nicotine replacement therapy (NRT) in pregnancy. Experts agree that nicotine replacement is safer than continuing to smoke in pregnancy. Although a pharmacotherapy-free attempt is initially recommended, if abstinence is not able to be achieved in the first few days, the women should be offered an accelerated option of NRT starting with oral forms and then, if required, progressing to nicotine patch or combined oral and transdermal therapy. Support should be offered for at least 12 weeks and post-partum. Offering counselling and cessation support to partners and family is also important, as is linking the woman in with appropriate social and community support and Aboriginal specific services. As long as oral forms of NRT are not included in the Pharmaceutical Benefit Scheme for Aboriginal and Torres Strait Islander women a significant and inequitable barrier will remain.

Item ID: 32486
Item Type: Article (Research - C1)
ISSN: 1834-2612
Keywords: smoking cessation, maternal smoking, Aboriginal and Torres Strait Islander peoples, nicotine replacement therapy, clinical guidelines, behavioural counselling
Funders: National Health and Medical Research Council (NHMRC), National Heart Foundation
Projects and Grants: NHMRC APP 1039759
Date Deposited: 17 Nov 2015 01:57
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 80%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111716 Preventive Medicine @ 10%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 10%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 45%
92 HEALTH > 9202 Health and Support Services > 920208 Health Inequalities @ 10%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920414 Substance Abuse @ 45%
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