Provision of Antenatal Smoking Cessation Support: A Survey With Pregnant Aboriginal and Torres Strait Islander Women

Introduction: Guidelines recommend assessment of smoking status, with advice and support for smoking cessation, as a routine and integral part of antenatal care. Approximately 50% of pregnant Australian Aboriginal and Torres Strait Islander women smoke through pregnancy, 3 times the rate of other pregnant Australian women. This study describes smoking cessation assessment and support reported by pregnant Aboriginal and Torres Strait Islander women. Methods: Surveys of 261 pregnant Aboriginal and Torres Strait Islander women in New South Wales and the Northern Territory, Australia assessed women's reports of assessment, advice and support for smoking cessation from antenatal providers. Results: The majority of women (90%, 95% CI = 85, 93) reported being asked their smoking status; 81% (95% CI = 73, 87) of smokers reported being advised to stop smoking and 62% (95% CI = 53, 71) of smokers reported being offered support to quit. Conclusions: Despite most pregnant women who smoke reporting advice and support to quit, the persisting high prevalence of smoking suggests that this support is insufficient to overcome the many factors pushing women to smoke. Improving the support provided to women will require empowering the antenatal providers with adequate skills, appropriate resources and effective interventions. Current guidelines are based on research from non-Indigenous populations, as there are no published effective interventions for Indigenous pregnant women. Trials of interventions designed specifically for pregnant Aboriginal and Torres Strait Islander women are urgently needed, as are approaches aimed at reducing uptake of smoking.