Nursing

It is generally agreed that smoking may lead to numerous, serious health related complications. These health complications are not limited to only the smoker. For example, second hand-smoke can greatly effect third-parties. More so, smoking during pregnancy can have negative effects on the health of the unborn baby. One common problem is the occurrence of spontaneous abortions. Several studies have demonstrated that tobacco use is a major factor in the cause of spontaneous abortions among pregnant smokers. Studies have also shown that smoking during pregnancy can be the cause of several other threats to the health of the fetus. Even second-hand smoke can be dangerous to the fetus, being sited as a cause of early pregnancy loss. Specifically, second hand smoke is most often connected to sudden infant death syndrome. Studies have shown that infants who die from sudden infant death syndrome typically have had higher concentrations of nicotine and cotinine in their lungs. Cotinine is a biological marker for having been exposed to second hand smoke. Although smoking while one is pregnant certainly increases the risk for an incident of sudden infant death syndrome, those who are exposed to second hand smoke are actually at a greater risk for the incident than those who have mothers who smoked during pregnancy.

Clearly, smoking or even just being exposed to smoke during a pregnancy can have serious, even deadly, health effects on a fetus. Fully understanding the potential threats that smoking during pregnancy can cause is essential knowledge for any nurse to have. With a clear understanding of the effects, a nurse will be better able to explain the threats to their patients and thus potentially limit some of the complications. To assist with this understanding, the following in-depth literature review on the subject is presented:

Moner, S.E. (1994): “Smoking and Pregnancy.” Canadian Guide to Clinical Preventive Health Care. Ottawa: Health Canada; p. 26-36.

This research was conducted by the Canadian Task Force on the Periodic Health Examination. This study not only looks at what the effects of smoking during pregnancy are, but, more importantly, what steps are most effective in preventing a pregnant mother from smoking during pregnancy. This study was conducted using a combination of literature review, personal consultations and records reviews. The results found that advice, multiple component programs, behavioral strategies, repeated contacts and self-help manuals are effective in significantly decreasing tobacco smoking in pregnant women.

England, Lucinda J., Kendrick, Juliette S., Wilson, Hoyt G., Merritt, Robert K., Gargiullo, Paul M., and S. Christine Zahniser. (2001): “Effects of Smoking Reduction During Pregnancy on the Birth Weight of Term Infants.” American Journal of Epidemiology. Vol. 154, No. 8: 694-701.

This research was conducted by leading health care professionals and studies whether reducing tobacco exposure during pregnancy increases birth weight of term infants and the relative effects of early and late pregnancy exposure to tobacco on the birth weight of infants. It was conducted by gathering data from the Smoking Cessation in Pregnancy project, which was conducted in public clinics in Colorado, Maryland, and Missouri between 1987 and 1991 on 1,583 pregnant smokers. The results showed that reducing cigarette use is associated with an increase in the mean birth weight of an infant, thus leading to the conclusion that women who smoke during pregnancy may need to reduce to use in order to improve their infant’s birth weight.

Bailey, Diane, Taylor, Polly and Jeanette Zaichkin. (2002): Smoking Cessation During Pregnancy: Guidelines for Intervention. Washington State: Maternal and Child Health Division of the State Department of Health.

This study was conducted by three nurse practioners in the state of Washington. The research focused on finding the best methods of providing effective intervention to smoking mothers in order to reduce the effects of smoking during pregnancy on the infant. The study was a review of all the intervention methods used throughout the state. The study concludes that the most effective intervention tool for a pregnant woman who smokes less than twenty cigarettes per day is to use the Brief Intervention method.

Sadowski, Kelly, and Thomas G. Parish. (2005): “Maternal Smoking Contributes to the Development of Childhood ADHD.” The Internet Journal of Allied Health Sciences and Practice. Vol. 3, No. 1. http://ijahsp.nova.edu.

This study was conducted by two leading health care providers at the University of Nova Scotia. It was conducted by reviewing literature concerning maternal cigarette smoking during pregnancy. The review was performed by utilizing Medline, CINAHL, and Pubmed. It concluded that there is a link between smoking during pregnancy and increased incidences of behavioral disorders, specifically Attention Deficit Hyperactivity Disorder, however a direct causative relationship was not established.

Benowitz, Neal L. And Delia a. Dempsey. (2004): “Pharmacotherapy for Smoking Cessation During Pregnancy.” Nicotine & Tobacco Research. Volume 6, Supplement 2.

This study was conducted by two pharmacotherapy specialist and was conducted on a controlled group of smoking pregnant mothers. The purpose of the research was to discover the benefits of pharmacotherapy as a method of intervening with preventative treatment for smoking mothers and thus preventing the numerous harmful effects to the fetus the smoking during pregnancy may cause.

The study concluded that there was a beneficial relationship between pharmacotherapy and getting pregnant mothers to stop smoking. Thus, a conclusion was assumed that pharmacotherapy was a successful method at preventing birth defects associated with smoking during pregnancy.

Cogswell, Mary E., Weisberg, Pamela, and Catherine Spong. (2003): “Cigarette Smoking, Alcohol Use and Adverse Pregnancy Outcomes: Implications of for Micronutrient Supplementation.” The American Society for Nutritional Sciences Journal of Nutrition. 133:1722S-1731S.

This study was a literature review examining the question of whether or not smoking or alcohol use during pregnancy increases maternal micronutrient requirements and whether smoking or alcohol use interacts with micronutrient deficiencies to affect pregnancy outcomes. The study found that these actions did increase micronutrient requirements and deficiencies, thus concluding that health care practitioners should increase nutrient levels in pregnant women who do not meet the recommended allowances in their diet.

Cornelius, Marie D. And Nancy L. Day. (2000): “The Effects of Tobacco Use During and After Pregnancy on Exposed Children.” Relevance of Findings for Alcohol Research. Vol. 24, No. 4.

This study was conducted by two PhD level professors of health studies and consisted of a literature review of various studies in order to better understand the effects of prenatal tobacco exposure so that caregivers will be better able to identify the characteristics of its effects and better treat their unique needs. The study concludes by showing that tobacco use during pregnancy does negatively effect the fetus and thus preventing various types of substance use during pregnancy and treating children affected by prenatal substance use is beneficial to the well-being of the child.

Fellows, JL, Trosclair, a., and Adams, EK. (2002): “Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs- United States, 1995-1999.” MMWR Weekly. 51(14); 300-303.

This study reviews the mortality rate of children who were exposed to a smoking mother during pregnancy. The study is conducted by reviewing the mortality rates found in medical records across the nation. It is conducted by several PhD level researchers. According to the finds, over 599 male infants were killed as a result of their mothers smoking during pregnancy.

Centers for Disease Control and Prevention. (2002): “Women and Smoking: A Report of the Surgeon General.” Morbidity and Mortality Weekly Report. 51(RR12); 1-30.

This report conducted by the U.S. federal government provides a comprehensive review of the effects that smoking has specific to females. It is conducted by doing a thorough review of national medical statistics. It concludes that, as related to smoking during pregnancy, that smoking has a negative effect not only on the mother but, more importantly, on the unborn infant.

Hill, Mark. (2006): “Maternal Effects-Smoking and Pregnancy Workshop.” The University of New South Wales UNSW Embryology Quarterly.

Giglia, Roslyn C., Binns, Colin W., and Alfonso Helman. (2006): “Which Women Stop Smoking During Pregnancy and the Effect on Breastfeeding Duration.” Biomed Central. http://www.biomedcentral.com/1471-2458/6/195

Torfs, Claudine P. And Roberta E. Christianson. (2000): “Effect of Maternal Smoking and Coffee Consumption on the Risk of Having a Recognized Down Syndrome Pregnancy.” American Journal of Epidemiology. Vol. 152, No. 12: 1185-1191.

Solomon, Laura J. And Virginia P. Quinn. (2003): “Spontaneous Quitting: Self Initiated Smoking Cessation in Early Pregnancy.” Nicotine and Tobacco Research. Vol. 6, Sup. 2; S203-S216.

Kleinman, Michael. (2000): “The Health Effects of Air Pollution on Children.” Irvine: University of California.

Eichhammer P, and Johann M. Kharraz. (2003): “High Frequency Repetitive Transcranial Magnetic Stimulation Decreases Cigarette Smoking.” Journal of Clincial Psychiatry. 64:951-953.

In conclusion, the literature presented clearly shows that smoking during pregnancy does have an adverse affect on infants and fetuses and that through the proper treatment and counseling, these effects can be mitigated either before they happen or after the infant is born. However, the literature review shows that the research thus far conducted is limited in that there is no conclusive evidence as to the best method for preventing smoking during pregnancy. Therefore, all future research should be focused not on what the effects are, as this is already known, but how best to get pregnant mothers to cease smoking.