Stopping smoking - again
Three recent studies examined the effectiveness of interventions, or programs, to reduce smoking during pregnancy. The programs were integrated into routine prenatal care services. The interventions were introduced to subjects by either an obstetrician or a health educator; women were also given a self-help smoking cessation manual. The ability of pregnant women to stop smoking was assessed by measuring blood levels of biochemical markers of tobacco use. These studies illustrate the use of behavioral methods directed at reducing smoking in pregnant women. One of the studies also used a personal feedback approach in which the levels of cotinine, a by-product of smoking, were reported to the mother and discussed in terms of effects on birth weight. A feedback approach that involved showing mothers their carbon monoxide levels did not alter smoking behavior, whereas feedback involving the demonstration of fetal activity was successful in reducing smoking. Demonstration of low birth weight is not necessarily perceived by mothers as undesirable. The studies of interventions to reduce smoking also provided information about birth weight, duration of pregnancy among smokers, and fetal and infant deaths. The use of interventions to reduce smoking among pregnant women resulted in higher birth weights. However, the relation between reduction in smoking, preterm delivery, and birth-related deaths requires further study. Interventions that are both effective and inexpensive should be assessed and tested in large numbers of subjects. Obstetricians and midwives should be able to provide their pregnant patients who smoke with information concerning smoking cessation; they should also participate in efforts to reduce smoking in the general population. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
The wrong way to stay slim
Anti-smoking campaigns need to focus more on prevention of smoking among teenagers, the connection between smoking and weight maintenance, and women's desires to be thin. Most people begin smoking before they are 21 and unsuccessfully try to quit thereafter. Although most teenagers are aware of the dangers of smoking, many begin smoking because it is associated with having friends and being successful and thin. Tobacco advertisements play into these associations, and ads targeted at women particularly emphasize being thin. These ads have been effective as the rates at which women smoke and die of lung cancer have increased remarkably since women were first targeted by advertising in the 1960s. A 1995 study showed that quitting smoking may lead to a weight gain of four to five kilograms. Many women may start smoking, or at least not quit smoking, because of a fear of gaining weight. More research must be done to better understand why teenagers begin smoking and how to prevent them from doing so.
Publication Name: The New England Journal of Medicine
Healthy families make healthy babies
Public health officials must work to provide care for pregnant women in order to reduce the problem of low birth weight among infants in developing countries. Nutrition, smoking and the need for rest are discussed.
Publication Name: World Health
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