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Abstract

This study aims to find the most effective interventions in smoking cessation amongst Australian women by bringing forward most common conclusions made in previous literature. Smoking remains the leading cause of stillbirth, preterm birth and miscarriage that can be prevented. This is a qualitative research based on secondary data gathered from already published articles and the findings are deductive of the experiment results obtained from the data gathered from previous studies. Limited education, unsupportive partner, depression, low socioeconomic status, lack of awareness, disadvantaged areas (Aboriginals and Torres Strait Islanders), inefficient counselling, and smaller age are the main characteristics that pregnant smokers seem to have in common. Previous studies indicate that awareness campaigns do result positively as mothers tend to quit smoking when they are educated of the dangers of smoking. The three most experimented interventions are awareness through text services, educating health providers in disadvantaged areas and better counselling of the pregnant women. Innovative methods to spread the message would result in better response from the underprivileged areas. Higher level of training of nurses and midwives show better results in smoking cessation. The study uses systematic review approach to connect all the literature to find the best proven interventions for promoting smoking cessation in pregnant women.   

Introduction

Fetal growth can be restricted due to a mother’s smoking habit, a study in utero shows that the birthweight of a baby, whose mother has smoked during pregnancy, is lesser than a baby whose mother is a non-smoker (Fatima Lockhart, 2017). These growth problems are seen carried into childhood and even adulthood. Low birthweight are proven to be a cause for higher probability of heart problems in adulthood which means that not only does smoking causes harm to the fetus at before birth but potentially can cause problems through-out the life of the person (Luke Arnold, 2015). In Australia 14.5% of women admit to smoking while they are pregnant but the real percentage of pregnant smokers is said to be about 25% as many women do not admit to it. Nicotine reduces blood flow to the fetus and carbon monoxide restrict oxygen flow to the fetus which can cause a range of health concerns from a delayed birth to a miscarriage. About 45% of women smokers quit smoking when they get pregnant of these most women are from higher social status, quitting during pregnancy reduces health problems but still a non-smoker would be in a better position to give birth to a healthier baby. The biggest concern lies in Aboriginal and Torres Strait Islander mothers as 49.3% of these mothers have been reported to smoke in pregnancy, these women enter pregnancy without planning for it and go into antenatal care in the later stage of pregnancy hence eliminating any chance of early smoking intervention cessation (Colin P. Mendelsohn, 2014). Not only in Australia but also in the U.S. the number of pregnant smokers is higher in lesser educated sector. There have been some missed opportunities to spread awareness of the problems that smoking causes the fetus and there is a need to introduce some innovative schemes that would educate these pregnant smokers about the harms this habit causes to their babies, which is main reason mothers have to quit smoking. A health text messaging program can promote smoking cessation amongst pregnant women who have already subscribed to such a service (Lorien C. Abroms, 2017). 

Smoking amongst pregnant women in Australia is linked to several factors that mainly include low socioeconomic status, unsupportive partner, presence of smokers around the women, depression, addiction, women who already have given birth, not highly educated, little social support and psychiatric disorder. Women in areas of disadvantage are 6 times more likely to smoke during pregnancy (Greenhalgh, 2019). Feedback, incentives and behavioral counselling are the main interventions that have to be worked on in order to increase smoking cessation in pregnant women using different methods like the text service and educating health providers show optimistic results even when applied to disadvantaged areas. It is important to obtain feedback and test the sample population to maintain the credibility of such a research (Chamberlain C., 2017).     

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