REDUCING HARM ã®ã³ãã¼
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PRESENTATION OUTLINE
SMOKING DURING PREGNANCY
MARGARET S. CHISOLM, MD Â Â @WHOLE_PATIENTS
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Untitled Slide
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1964 SURGEON GENERAL'S REPORT
ANNOUNCED HEALTH RISKS OF SMOKING & LAUNCHED MASSIVE PUBLIC HEALTH CAMPAIGN
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REPORT ALSO NOTED RISK OF LOW BIRTH WEIGHT
IN BABIES BORN TO MOTHERS WHO SMOKED
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IN THE FACE OF DWINDLING SALES
COMPANIES INCREASINGLY FOCUSED ON FEMALE MARKET
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AND ON PERCEIVED REDUCTION OF HARM
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IN THE 1990s, SMOKING PREVALENCE IN WOMEN INCREASED
FOR THE FIRST TIME SINCE THE 1960s
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SINCE THEN, LITTLE CHANGE IN SMOKING PREVALENCE
NOW CONCENTRATED IN WOMEN OF LOW SES &/OR WITH PSYCHIATRIC COMORBIDITY
Photo by Much Ramblings
LOW BIRTH WEIGHT PRETERM DELIVERY SPONTANEOUS ABORTION STILLBIRTHS NEONATAL MORTALITY INTRAUTERINE GROWTH RESTRICTION PREGNANCY COMPLICATIONS SUDDEN INFANT DEATH SYNDROME
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50% OF WOMEN CONTINUE TO SMOKE DURING PREGNANCY
THIS 11% PREVALENCE HAS REMAINED UNCHANGED FOR >20 YEARS
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BEHAVIORAL TREATMENTS
SIGNIFICANTLY REDUCE MATERNAL SMOKING & IMPROVE NEONATAL OUTCOMES
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PHARMACOLOGICAL TREATMENTS
3 FIRST-LINE TREATMENTS SAFE & EFFECTIVE IN NON-PREGNANT ADULTS
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PHARMACOLOGICAL TREATMENTS
3 FIRST-LINE TREATMENTS SAFE & EFFECTIVE IN NON-PREGNANT ADULTS
Photo by arbyreed
4 RANDOMIZED CONTROLLED TRIALS IN PREGNANCY
NONE EFFICACIOUS AT ENHANCING QUIT RATES
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BUPROPION & VARENICLINE
Photo by CarbonNYC [in SF!]