Nicotine replacement prescription practices of obstetric and pediatric clinicians
Department of Medicine, Division of Preventive and Behavioral Medicine
Adult; Boston; Drug Utilization; Female; Humans; Infant; Infant, Newborn; Male; Nicotine; *Obstetrics; *Pediatrics; Physician's Practice Patterns; Pregnancy; *Smoking Cessation
Life Sciences | Medicine and Health Sciences | Women's Studies
OBJECTIVE: To assess smoking cessation counseling and nicotine replacement therapy prescription and recommendation practices among obstetric and pediatric providers.
METHODS: We sent out a self-administered survey to 61 obstetric and pediatric nurse practitioners and physicians at six community health centers in the Boston area.
RESULTS: Obstetric providers were more likely to view smoking cessation counseling as their responsibility in treating pregnant women than pediatric providers did in treating infants with mothers who smoked (mean +/- standard deviation [95% confidence interval] 4.5 +/- 0.76 [4.2, 4.8] versus 4.0 +/- 0.8 [3.7, 4.3] on a five-point scale; P <.05). Obstetric providers believed that smoking cessation counseling was more effective than did pediatric providers (3.45 +/- 1.1 [3.0, 3.9] versus 2.8 +/- 0.8 [2.5, 3.1] on a five-point scale; P <.05) and were more likely to report provision of cessation assistance than pediatric providers (63% [44%, 82%] versus 17% [5%, 29%]; P <.05). Obstetric providers were more likely to prescribe or recommend over-the-counter nicotine replacement therapy than pediatric providers (44% [25%, 63%] versus 11% [1%, 21%], P =.004). Reasons for not prescribing nicotine replacement differed according to specialty; however, perceived lack of efficacy was not a typical reason given by clinicians in either specialty. Only two of 47 practitioners who did not prescribe or recommend those therapies listed that as a factor in their decisions.
CONCLUSION: We found that nicotine replacement therapies are commonly prescribed or recommended to pregnant smokers by obstetric providers, but less commonly to lactating women by pediatric providers.
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Citation: Obstet Gynecol. 2000 Aug;96(2):261-5.
Oncken, Cheryl A.; Pbert, Lori; Ockene, Judith K.; Zapka, Jane G.; and Stoddard, Anne M., "Nicotine replacement prescription practices of obstetric and pediatric clinicians" (2000). Women’s Health Research Faculty Publications. 389.