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A Pragmatic Guide for Smoking Cessation Counselling and the Initiation of Nicotine Replacement Therapy for Pregnant Aboriginal and Torres Strait Islander Smokers

Published online by Cambridge University Press:  31 March 2014

Gillian S. Gould ,
Renee Bittoun  and
Marilyn J. Clarke
Gillian S. Gould*
Affiliation:
School of Public Health, Tropical Medicine and Rehabilitation Science, James Cook University, Cairns, Queensland School of Health and Human Sciences, Southern Cross University, Coffs Harbour, New South Wales
Renee Bittoun
Affiliation:
Brain & Mind Research Institute, Sydney University, New South Wales
Marilyn J. Clarke
Affiliation:
Northern NSW Local Health District, Grafton, New South Wales
*
Address for correspondence: Dr Gillian S. Gould PO Box 9077, Moonee Beach 2450, NSW Email: gillian.gould1@my.jcu.edu.au
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Abstract

Smoking prevalence of pregnant Aboriginal and Torres Strait Islander women is quadruple that of pregnant women in the Australian population, and is associated with significant adverse outcomes in pregnancy. While cessation is a priority, there is as yet little evidence for effective interventions. This paper provides a pragmatic approach to addressing the complexities of smoking in pregnant Aboriginal and Torres Strait Islander peoples and informs clinicians about the initiation of nicotine replacement therapy (NRT) in pregnancy. Experts agree that nicotine replacement is safer than continuing to smoke in pregnancy. Although a pharmacotherapy-free attempt is initially recommended, if abstinence is not able to be achieved in the first few days, the women should be offered an accelerated option of NRT starting with oral forms and then, if required, progressing to nicotine patch or combined oral and transdermal therapy. Support should be offered for at least 12 weeks and post-partum. Offering counselling and cessation support to partners and family is also important, as is linking the woman in with appropriate social and community support and Aboriginal specific services. As long as oral forms of NRT are not included in the Pharmaceutical Benefit Scheme for Aboriginal and Torres Strait Islander women a significant and inequitable barrier will remain.

Keywords

tobacco smokingAboriginesAustraliansmoking cessationnicotine replacement productsprenatal care
Type
Protocol
Information
Journal of Smoking Cessation , Volume 10 , Issue 2 , December 2015 , pp. 96 - 105
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2014 

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