Tobacco Talk: A Provider Must

By Steffie Duginske, Western Regional Coordinator

As a health educator, I am interested in my health and the health of others.  However, I am also a former cigarette smoker and understand tobacco addiction all too well.  Like so many others, I started young - 14 years old - for the typical reasons.  I wanted to fit in with a friend.  I was definitely addicted well before high school graduation.  Sadly, it took me 10 years to finally kick the habit.  On a positive note, I’m one of the lucky ones who quit for good.  Of the nearly 69% of adult smokers in 2010 who wanted to quit, more than 50% tried but only 6.2% succeeded.1

I would like to use this blog to talk not about prevention (of course it’s best to not even start) but rather on the benefits of cessation counseling for those who are already addicted. At the Campaign we focus especially on women of childbearing age, as their tobacco use can impact their own health plus the health of a future or current pregnancy. For many women, including me, it is the advice of a health care professional that prompts them to action.

The March of Dimes NC Preconception Health Campaign supports health care professionals with its 5A’s Tobacco Cessation Counseling provider training.  As a health professional, you are an important motivator to change patient behavior. Many studies have demonstrated that recommendations and counseling from health professionals can play a significant role in patients’ attempts to change negative health behaviors.

Yes, I had reached a point in my life where I was really ready to quit.  It was my first year teaching high school health and physical education in a small rural town, and I was a closet smoker (not to mention a bad example to my students should they find out).  But it was not until I became very sick with bronchitis and the flu followed by a trip to the local doctor that finally pushed me to quit for good.  The exact words of the doctor when he looked into my mouth were, “Have you ever smoked?” He continued by telling me that he could actually see the effects of smoking in the back of my throat, and stressed the importance of quitting while I was young.  It was the motivation I needed to begin the quitting process.

I’m not going to lie, quitting smoking was one of the hardest things I’ve ever done, but I’m glad I did it before I became pregnant with my children.  As we all know, the news of pregnancy certainly brings joy, but it can also bring stress both during and after pregnancy as new mothers and families begin to juggle everything that comes with work, life, family, and those precious babies.  To handle the stress, unfortunately, 45%-70% of women who quit smoking during pregnancy relapse within 1 year of delivery; which is why tobacco counseling is so important not only before and during pregnancy, but after pregnancy as well.

Studies show that a brief counseling intervention of 5-15 minutes (such as the 5As), when delivered by a trained health care professional, along with pregnancy-specific self-help materials, can double or even triple smoking cessation rates among pregnant women.  In fact, if it were possible to eliminate smoking during pregnancy entirely, the infant mortality rate in North Carolina would drop 10-20%.2  For those patients who are pregnant, women are more likely to quit at this time than any other time in their lives.  These women are motivated by the outcome of having a healthy baby.

By advising your patients in a clear, strong, personalized, non-judgmental tone while focusing on the positive benefits of quitting that will personally affect them, they are one step closer to dropping the very costly and harmful tobacco habit.  Remember to consistently use the 5 A’s:  ASK, ADVISE, ASSESS, ASSIST, AND ARRANGE.  If you want to know more about this evidence-based tobacco use cessation training designed for healthcare providers and office personnel, contact one of our local campaign coordinators to set up a free training in your office today. 

I personally understand tobacco addiction more than I’d like to.  I am just one example of cessation success.  But, with consistent, ongoing, empathetic messages from providers to encourage women to quit, you can drastically impact the health of women and their babies.  Remember, patients value the opinion of their health care provider. Don’t put off talking to your patients about their tobacco use.  They are listening.

  1. Wall Street Journal/CDC, Canadian Journal of Surgery, Archives of Internal Medicine.
  2. Rosenberg DC, Buescher PA. The Association of Maternal Smoking with Infant Mortality and Low Birth Weight in North Carolina, 1999. SCHS Studies No. 135. Raleigh, NC: North Carolina State Center for Health Statistics; 2002
Revised: June 28, 2013

This web site is designed for informational use only; it is not designed to give advice, diagnose, cure or treat any medical condition you may have. If you have any questions about your health, please contact your health care provider.