Christina Cantin,Wendy E.Peterson,Barbara Davies and Kirsten Woodend
Background: Approximately 6-30% of Canadian women smoke during pregnancy. Prenatal care visits are an opportune time for Family Practice Nurses to provide evidence-based smoking cessation interventions. The purpose of this exploratory study was to describe: 1) Smoking cessation interventions by Family Practice Nurses during prenatal visits; 2) Family Practice Nurses' awareness and use of smoking cessation guidelines as well as the proportion of Family Practice Nurses who engage pregnant women who smoke in minimal interventions and intensive interventions; 3) the predictors of nurse-provided smoking cessation counseling for pregnant women and 4) the barriers to smoking cessation counseling. Methods: A previously validated questionnaire measuring smoking cessation counseling practices was modified and converted to an electronic format. A bilingual invitation was emailed to the members of Ontario Family Practice Nurses' interest group of the Registered Nurses' Association of Ontario, Canada. Descriptive and multivariate analyses were completed. Predictors investigated included nurses' age, beliefs about their role in smoking cessation, self-efficacy to provide effective counseling, smoking cessation training, and interest in updating smoking cessation knowledge. Eighty-nine Family Practice Nurses working in primary care settings across Ontario, Canada responded. Results: Nurses with higher levels of self-efficacy were more likely to provide smoking cessation counseling. Although nurses Ask, Advise and Assess, they are less likely to provide concrete assistance in the quitting process or arrange follow-up. The most commonly cited barriers to nurse-provided smoking cessation counseling included cost of medication, lack of time, and lack of knowledge. Fourteen percent of respondents reported that they never offer smoking cessation counseling to pregnant women. Conclusions: Family Practice Nurses are not consistently providing evidence-based smoking cessation interventions for pregnant women. Disseminating research outlining effective strategies to increase nurses' selfefficacy to provide effective smoking cessation interventions may increase the uptake of evidence-based recommendations.