PRENATAL SMOKING CESSATION COUNSELING BY TEXAS OBSTETRICIANS

Background: Smoking during pregnancy causes 20 to 30 percent of low bi rthweight and IO percent of infant mortality in the United States. Bri ef counseling can reduce rates of smoking. The study objectives were t o describe Texas obstetricians' pregnancy smoking cessation counseling activity and to identify attributes associated with consistent, effec tive counseling. Methods: A survey was mailed to a random sample of Te xas obstetricians. Results: A response rate of 44 percent (n=204) was attained A counseling coverage-effectiveness index was created based o n the percentage of smokers counseled and use of specific techniques. Almost all respondents reported asking about smoking; fewer however re ported counseling smokers. Physicians with low inner scores, indicatin g inconsistent coverage, ineffective counseling, or both were dissatis fied with their current counseling, did not perceive counseling to dec rease smoking, were not aware of the risks of smoking, and were unfami liar with expert reports and recommendations for prenatal care. Conclu sions: Obstetricians who are not reached by expert reports and guideli nes from groups outside their specialty or who do not perceive the ser iousness of maternal smoking are less likely to counsel consistently a nd to use the most effective techniques. Continuing medical education at local, state, and national levels should be directed toward increas ing knowledge and skills about smoking cessation counseling of pregnan t women.