Smoking and pregnancy.

Smoking is associated with decreased fertility in both males and females, an increased abortion rate, lowered birth weight, an increased still birth rate and probably an increased neonatal death rate. There is also a reduced incidence of maternal hypertension (although the babies are at even greater risk), an increased incidence of ante-partum haemorrhage, impaired brain development and possible teratogenic effects. These effects can be reversed if the mother gives up smoking in pregnancy.     

Smoking cessation during pregnancy

Smoking during pregnancy is associated with maternal, fetal, and infant morbidity and mortality. An office-based protocol that systematically identifies pregnant women who smoke and offers treatment has been proven to increase quit rates. For pregnant women who smoke less than 20 cigarettes per day, the provision of a 5-15 minute, five-step counseling session and pregnancy-specific educational materials increases cessation by 30-70%. This bulletin outlines this office-based intervention and addresses treatment issues pertaining to pregnant women who smoke heavily, smoking reduction, pharmacotherapy, healthcare support systems, and coding.     

Smoking and alcohol consumption during pregnancy: an epidemiological study in Tasmania

Smoking and alcohol ingestion were analysed in 5100 women confined in Tasmania in 1981. This represented 70% of the total number of confinements. The incidence of smoking throughout pregnancy was 33.6%, and 2.7% of the women studied smoked at some time during pregnancy. Alcohol consumption in pregnancy was recorded for 55.9% of patients. However, 99% were only occasional drinkers. There was a statistically higher incidence in smoking habits in the age group 20 years and under, the unmarried and the lower socio-economic classes, whereas the reverse was true for alcohol consumption. The analysis provides a basis for the groups toward which programmes should be directed.     

Smoking and caffeine and alcohol intake during pregnancy in a northern population: effect on fetal growth.

OBJECTIVES: To assess the prevalence of smoking and of caffeine and alcohol intake during pregnancy in a northern population and to determine the relation of these factors to birth weight, length and head circumference. DESIGN: Questionnaire survey and collection of maternal and newborn measurements. SETTING: Ten communities in the Inuvik Zone, NWT. PATIENTS: A total of 162 women (56 Inuit, 38 Indian, 37 white and 31 mixed race) who presented for prenatal care in their community and gave birth in Inuvik between September 1987 and January 1990 and their newborns. RESULTS: In all, 64% (101/159) of the women smoked, 57% (88/154) ingested more than 300 mg of caffeine daily, and 34% (50/145) drank alcohol during their pregnancy. Smoking, caffeine intake and binge drinking were most frequent among the Inuit and Indian mothers. Smoking was significantly associated with decreased birth weight (p less than 0.001) and length (p less than 0.05). Alcohol intake, especially binge drinking, was significantly associated with decreased head circumference (p less than 0.05). Caffeine was found not to be related to any of the outcome variables after smoking was controlled for through stepwise multiple regression. CONCLUSIONS: The marked prevalence of smoking and alcohol intake during pregnancy and their effects on the newborn are public health concerns in the Northwest Territories and warrant intensive countermeasures.     

Smoking in pregnancy: associations with skinfold thickness, maternal weight gain, and fetal size at birth

Skinfold thickness is an index of subcutaneous fat, and certain maternal conditions during pregnancy affect the skinfold thicknesses of the baby. A study was performed to investigate the effect of smoking on skinfold thickness, maternal weight gain, and fetal size at birth. A total of 452 mothers with normal singleton pregnancies were groups as: non-smokers, light-to-moderate smokers, or heavy smokers. Maternal age, height, parity, and duration of pregnancy were similar in the three groups. Heavy smokers gained significantly less weight than non-smokers, but there was no significant difference in skinfold thickness. Babies born to smokers had lower birth weights and smaller head circumferences and were shorter than those born to non-smokers, but skinfold thicknesses were similar. The presence of a normal layer of subcutaneous fat in babies whose mothers smoked suggests that fetal growth retardation is not caused by nutritional deficiencies.     

Smoking in nurses.

An anonymous questionnaire requesting information on smoking habits was administered to 220 randomly chosen trainee and registered nurses (159 females and 61 males). There was no significant difference between the proportion of male nurses (55-7%) and the proportion of males (45-0%) in the Australian sample who smoked. However, the 52-2% of female nurses smoking was significantly greater than the 29-0% reported for the Australian female population. There was some indication that the increased smoking in female nurses reflected a response to stress. Further analysis showed that nursing personnel were giving up smoking at the same rate as the general Australian sample.     

Smoking in childhood.

A longitudinal study of smoking in a cohort of 6000 children aged 11-12 years is being carried out in Derbyshire. One of the main objectives is to discover the factors which influence children to take up smoking. Once such factors are determined intervention methods can be developed to discourage children from smoking which, it is hoped, will result in a reduction in mortality and morbidity from cigarette smoking.     

吸烟糖尿病患者戒烟干预的研究进展

吸烟是糖尿病发生、发展的重要危险因素。烟草中的尼古丁可通过影响胰岛素分泌、导致胰岛素抵抗和糖代谢紊乱等途径促进糖尿病的发生和发展,并加速糖尿病大血管和微血管的病变,而戒烟可降低糖尿病的患病率。有效的戒烟干预包括医务人员参与糖尿病吸烟患者的戒烟教育、制定合理的戒烟目标和对糖尿病患者进行戒烟心理干预等。该文专门针对吸烟的糖尿病患者,探讨吸烟与糖尿病的关系及如何进行戒烟干预。