Smoking cessation during pregnancy: strategies used by Michigan family physicians.

This study reports the attitudes and strategies of members of the Michigan Academy of Family Physicians about their antismoking interventions for pregnant smokers. Of the 978 physicians surveyed, 607 (62 percent) returned completed questionnaires. Three hundred twenty-three (53 percent) were not practicing obstetrics. The remaining 284 physicians currently practicing obstetrics constituted the study group. Ninety-four percent of these physicians routinely assessed smoking status at the first prenatal visit. Ninety-eight percent advised pregnant smokers to quit smoking during pregnancy. The most frequently used method of intervention was personal counseling (97 percent), followed by referral to smoking cessation clinics (40 percent), and behavior modification (20 percent). Fifty-seven percent of the physicians reported using antismoking pamphlets, and 30 percent used antismoking posters designed for pregnant women. Only 11 percent of the physicians surveyed were generally satisfied with the effectiveness of their current methods. Nonetheless, 97 percent were convinced that the benefits of smoking cessation during pregnancy merited their efforts. The physicians in this sample consistently have advised their pregnant smokers to quit, but most believe there is a need for more effective smoking cessation methods.