Caring for Aboriginal women who smoke
Many Aboriginal women quit smoking/tobacco before becoming pregnant, and others will stop as soon as they find out they are pregnant. Some Aboriginal women who smoke and want to stop will need a lot of support to quit smoking and remain smoke free.
Maternal smoking rates are higher in the Aboriginal community due to many factors. Smoking during pregnancy can be reinforced by what is considered ‘normal’ behaviour in the community as well as their family.
Quitting can be seen as a difficult thing to achieve. Despite strong protective feelings for their baby in their womb and a desire to quit, continued smoking is sometimes seen as something they need to do because their life is so stressful.
To ensure that a women’s interest in quitting is not hindered we must have:
- the attitudes of health professionals be kind, sincere and encouraging that the mother can quit successfully (not just cut down)
- the correct information about quitting in pregnancy that is sensitively communicated at every opportunity and as early as possible
- culturally sensitive support is offered (understanding of the mothers culture and the barriers to quitting that can be present).
There is no safe level of smoking during pregnancy. The ultimate goal should be to quit smoking, not just cut down.
Stopping smoking at any point in the pregnancy will improve outcomes – you can confidently tell women that it’s never too late to quit.
Support for stopping smoking should be offered at every opportunity throughout the pregnancy (and even post-partum).
Refer to the Aboriginal Quitline
Encourage that their home and car to be smoke free
Encourage their partner to stop smoking as well
Give culturally appropriate resources to take home
The Quitting Conversation
Every contact with a pregnant woman is an opportunity to deliver brief advice using Quit’s three-step Ask, Advise, Help model.
Smoking cessation brief advice from a doctor is effective, with one in 33 conversations resulting in a person successfully quitting.
Aboriginal and Torres Strait Islander women or a woman with an Aboriginal baby can speak to an Aboriginal Quitline counsellor.
Aboriginal Quitline counsellors provide culturally tailored and safe support.
When you refer to Quitline, there is an option of referring to an Aboriginal Quitline counsellor.
There are two ways to refer women to Quitline:
Download Referral Fax sheet below
Your health service or general practice may also have referral templates or automatic referral pathways embedded into medical record systems.
Is NRT safe during pregnancy?
If a pregnant women has tried to quit smoking cold turkey with adequate support and counseling but still isn’t able to quit, perhaps utilising Nicotine Replacement Therapy (NRT) is an option. NRT may help with the cravings but must be carefully monitored by a doctor.
For more information on the latest guidelines on how best to support smoking cessation go to RACGP Clinical Guidelines