Smoking and pregnancy

The risk of smoking during pregnancy is an issue for both Aboriginal and Torres Strait Islander and non-Indigenous women. However, there are particular concerns about the high rates of smoking reported for Aboriginal and Torres Strait Islander mothers [33934].

Smoking in pregnancy is a concern because of the poisons contained in tobacco and cigarettes, which can pass on to the unborn baby [23503]. Women who smoke when they are pregnant may have more problems than non-smokers during pregnancy and labour, and are at higher risk of:

• spontaneous abortion and miscarriage (when a pregnancy is involuntarily terminated before 20 weeks of gestation)
• ectopic pregnancy (when a fertilised egg is implanted outside the uterus, usually in the fallopian tubes)
• complications of pregnancy relating to the placenta and membranes, many of which can lead to preterm delivery (when the baby is born too early) [29610].

Smoking in pregnancy also means the baby may:

• be born too early (premature/preterm birth)
• be born too small (low birthweight)
• be at higher risk of Sudden Infant Death Syndrome (SIDS)
• have an increased risk of deformities [33934][29611].

Smoking is one of the most important preventable risk factors for complications in pregnancy and poor health outcomes for babies [26473]. It is best if mothers can stop smoking before getting pregnant, but the earlier they stop during pregnancy the better. It is also important for pregnant women to try to avoid being around smokers altogether [33934].

When women are pregnant, it is a good time for intervention as they may be more likely to consider making changes such as quitting or reducing smoking, to ensure the healthy development of their baby [29613]. As well as having positive health outcomes for the child, this can have a longer-term preventative effect; children who live with non-smokers are less likely to commence smoking themselves [29614].

Studies such as the 

trial have been implemented specifically to improve health provider’s skills when offering smoking cessation care to pregnant Aboriginal and Torres Strait Islander women [34736]. This study hopes to increase the proportion of health providers offering assistance in quitting to pregnant smokers, measured by prescription of nicotine replacement therapy (NRT), and a client checklist measuring overall quality of smoking cessation care. The study also aims to improve the quit rates of pregnant smokers, measured by carbon monoxide testing during pregnancy and after birth, as well as improving birth rates and respiratory outcomes of babies.