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General practitioner and obstetrician views on system changes to improve smoking cessation care in pregnancy in Australia: a cross-sectional survey

Published online by Cambridge University Press:  14 May 2020

Gillian Sandra Gould Open the ORCID record for Gillian Sandra Gould [Opens in a new window] ,
Simon Chiu ,
Christopher Oldmeadow  and
Yael Bar-Zeev Open the ORCID record for Yael Bar-Zeev [Opens in a new window]
Gillian Sandra Gould*
Affiliation:
School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales2308, Australia Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales2305, Australia
Simon Chiu
Affiliation:
Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales2305, Australia
Christopher Oldmeadow
Affiliation:
Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales2305, Australia
Yael Bar-Zeev
Affiliation:
School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales2308, Australia
*
Author for correspondence: Gillian Sandra Gould, E-mail: gillian.gould@newcastle.edu.au
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Abstract

Introduction

Systemic barriers impacting smoking cessation in pregnant women may include nicotine replacement therapy (NRT) access and training.

Aim

Assess general practitioner (GP) and obstetrician's agreement with system-based changes to improve the management of smoking in pregnancy; compare group responses.

Methods

National cross-sectional survey with two samples: (1) online survey emailed to a random sample of 500 GPs from Royal Australian College of General Practitioners (RACGP); (2) paper survey posted to 5571 GPs and obstetricians from Royal Australia and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Percentages agreeing that specified changes would improve the management of smoking in pregnancy were calculated. Pairwise comparisons used Kruskal–Wallis tests (RACGP/RANZCOG GPs/obstetricians).

Results

N = 378 participated. Response rates 8.4% (N = 42; online survey) and 6% (N = 335; paper survey), respectively. Total percentages agreeing with system-based changes: 79% training, 64% oral NRT subsidy, 62% Medicare item for smoking cessation, 54% improved access to NRT patches. Within RANZCOG, more GPs (73.1%) agreed that oral NRT should be subsidised (P = 0.001) than obstetricians (53.7%).

Conclusion

GPs and obstetricians agreed that system changes would improve their management of smoking in pregnancy. Oral NRT subsidy was the only pairwise group difference. Subsequently, oral NRT has been subsidised; in time, this may influence prescribing and quit rates.

Keywords

Clinician trainingnicotine replacement therapypregnancysmoking cessationsystem changes
Type
Original Articles
Information
Journal of Smoking Cessation , Volume 15 , Issue 3 , September 2020 , pp. 136 - 142
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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