Tobacco Use Among Pregnant Women in England

Introduction

Women have been smoking while pregnant since the invention of cigarettes in the world. This habit has reached peak levels such that it is uncommon to find a woman not puffing on the cigarette. It is common knowledge that the use of tobacco during pregnancy has adverse and fatal effects on the fetus in terms of growth, development as well as behavior. It is imperative for the pregnant mothers to be enlightened about the negativities that their indulgence has on their unborn children (Baghurst, Tong, Woodward, and McMichael, 2012, pp. 403-415). In this regard, it is pertinent for scholars, researchers, and practitioners to identify the common characteristics that make tobacco use dominant among pregnant women. It is significant that pregnant women are informed about the correlation of smoking and serious medical conditions such as cancer, heart diseases, and lung ailments. The purpose of this essay is to analyse the effects of smoking on women and their children during pregnancy in England. In order to achieve this insurmountable task, the paper takes an in-depth overview of the habit of women smoking during pregnancy in terms of the general trend and common traits of the behavior. Secondly, the paper discusses the common myths that have been advanced by the society towards smoking by pregnant women. Thirdly, the paper brings out the real facts about smoking during pregnancy by analyzing data from different sources so as to bring out a clear picture of the events on the ground. Additionally, describes the role of midwives in ensuring that pregnant women reduce the tendency of smoking during pregnancy as well as stopping the behavior all together. This paper also discusses the disparaging effects of smoking on pregnant women and their children. Finally, the paper states the possible mechanisms that can be adopted to mitigate against this behavior among pregnant women.

Women Smoking During Pregnancy

Overview

This trend has been worsening with increasing number of women engaging in this heinous and uncalled for behavior. Researchers and practitioners have asserted that smoking during pregnancy results in outcomes during birth that are not pleasant to the mother and the baby (Brook, Brook, and Whiteman, 2000, p. 381). Examples of these appalling effects include mothers delivering before the due date, children being born with less than minimum required weight, and children being born while dead. There exist a lot of evidence that links smoking during pregnancy and negative outcomes portrayed on the part of the born children (Day et al., 2012, pp. 407-414). These effects emanate from the fact that the smoking causes the children to undergo growth and maturation that are abnormal in nature. It has been discovered that any level of tobacco smoking is detrimental to the parent and the child. However, the intensity of smoking is considered great as a result of the number of cigarettes smoked on a single day (Wayne, 2014, pp. 13-26).

This has proved to have devastating and deleterious impacts on the unborn baby when compared to smoking that is light in nature. There is a lot of evidence that links maternal smoking and the negative outcomes experienced by the fetus and the infant. For example, it has been observed that smoking among pregnant women leads to the susceptibility of other risk behaviors developing. For instance, women who smoke during pregnancy are likely to die during delivery and develop complications of the placenta (Fox, Sexton, and Hebel, 2010, pp. 66-71). The behavior of women smoking during pregnancy is considered as one of the risk factors that is highly modifiable and associated with poor outcomes for women and their children. This is the reason as to why stakeholders have developed a range of strategies that help pregnant women to quit smoking during the gestation period (Wayne, 2014, pp. 13-26).

Myths

There are several myths about women smoking during pregnancy such as delivering healthy babies, small babies are cute, addiction, source of relaxation, cause of stress on the baby, it is good for the pregnancy, cold turkey is the only way out, and no need for breastfeeding (Fergusson, Woodward, and Horwood, 2014, p. 721). Women continue to engage in the smoking behavior during pregnancy as a result of having previously delivered healthy and bouncing babies. They develop lose hope that the current pregnancy will be safe and the children will be healthy. This is untrue since the probability of delivering a healthy baby while smoking does not depend on the behavior alone (Owen, McNeill, and Callum, 2008, pp. 728-730).

Smoking women do not get worried at the prospects of delivering small babies which is contrary to medical evidence that proves the humongous and arduous health complications associated with this type of babies (Griesler, Kandel, and Davies, 2008, pp. 159-185). It is important to understand that these effects set in at any time of the lifetime and are very adverse in nature. Moreover, pregnant women are of the notion that it is difficult to stop smoking during the pregnancy due to the permanence of the habit. Others feel that smoking is the primal source of relaxation on their part and also benefits the unborn children (Owen, McNeill, and Callum, 2008, pp. 728-730).

Pregnant women perceive that the children would be full of stress if they quit smoking during the gestation period. This is fallacious as continuing to smoke during pregnancy increases the magnitude of the negative effects on the fetus (Jacobson, Jacobson, and Sokol, 2014, pp. 317-323). Additionally, pregnant women feel that smoking tobacco is harmless and a good thing. This perception is misleading since scientists have proved that any threshold of smoking is detrimental and deleterious on the unborn children (Owen, McNeill, and Callum, 2008, pp. 728-730).

Facts

Various sources of data show how this occurrence has trended over the years. Women known to be smoking in England stand at 10.5 percent in 2016 from 11.2 percent in 2015. It is important to note that, this rate is way below the national target that stands at 11 percent (Kandel, Wu, and Davies, 2014, pp. 1407-1413). There are eloquent disparities among NHS England regions with regards to pregnant women smoking. For example, Cumbria records high rates of 16.1 percent while 4.8 percent is reported in London. Likewise, NHS Blackpool recorded prevalence at 25.0 percent while NHS Central London has a rate of 1.3 percent (Oncken, 2012, pp. 846-847).

The information being extracted from maternities country wide are of varying experiences. For example, there are maternities that do not have any database about the status of smoking at 2.6 per cent. However, this is a notable improvement from 3.0 percent in 2015 and further 3.2 per cent in 2016 (Kristjansson, Fried, and Watkinson, 2009, pp. 11-19). It is important to note that, the proportion of women smoking at the time of delivery should be clearly stated so as to avert confusion that emanates from the unknowns who are usually considered as non-smokers. This means that if the number of maternities with zero values of pregnant smokers were removed from the calculation, then the prevalence rate would stand at a whopping 12 percent (Oncken, 2012, pp. 846-847).

Role of Midwife Nurses

The midwives have critical roles to play in order to ensure that pregnant women stop or reduce the rate of smoking so as to avert the serious and fatal ramifications that are inevitable. These include identifying the victims, encouraging them to stop using cigarettes and supporting them where necessary. Smoking cessation is aimed at recognizing the presence of good smokers among the pregnant women so as to undertake the appropriate remedial actions (Owen, McNeill, and Callum, 2008, pp. 728-730). It is important for the nurses to note that almost 75 percent of pregnant smokers have the inherent desire to quit this deleterious behavior. A majority of the pregnant smokers have attempted to quit smoking on various occasions but their efforts have been futile. The most interesting aspect is that more than 90 percent of the pregnant smokers quit this habit without external intervention (England, 2010, pp. 694-701).

In this regards, the nurses have aforementioned special roles to execute in helping the less than 10 percent pregnant smokers to cease the trend. On a positive note, the nurses should appreciate the fact that pregnant smokers are willing and able to listen to them about stopping this negative behavior. In this context, nurses should use their professional ingenuity and discretion to initiate the process of ceasing this fatal habit (Owen, McNeill, and Callum, 2008, pp. 728-730). The pregnant smokers are expecting nurses to be friendly during the process through open talks that are confidential in nature. It is the role of the nurses to ensure that the willing pregnant smokers quit smoking so as to avert the adverse effects (England, 2010, pp. 694-701).

There are several types of interventions that the nurses can undertake to help pregnant women stop smoking. These include meetings, written materials, support person, telephone contact, replacement therapies, audio and video tapes, computer programs, referrals and home visits. The nurses can arrange regimen of meetings with the concerned women so as to initiate the process of smoke cessation (Owen, McNeill, and Callum, 2008, pp. 728-730). The meetings can vary in terms of duration and the intended purposes such as motivational talks, discussing barriers to cessation, and enlighten them about the risks associated with smoking during pregnancy. The nurses can talk about past professional cases, counsel the pregnant smokers, and engage in role-playing so as to reduce any negative feelings and symptoms that lead to depression. The number of interviews can vary depending on the degree of the smoking habit among pregnant women (England, 2010, pp. 694-701).

Nurses have the option of using written materials about smoking during pregnancy so as to help the pregnant smokers to overcome this habit. It is important to note that, written materials have proved to be beneficial towards curtailing the disparaging effects of this behavior. There are several types of written materials such as books, journals, magazines, newspapers, brochures, handouts and booklets among others (Owen, McNeill, and Callum, 2008, pp. 728-730). These should be distributed to both pregnant smokers and non-smokers every time they pay visits to the clinics. Similarly, the pregnant women of both statuses have the prerogative to undertake deliberate steps to follow the outlined guidelines about quitting smoking. These women should be given packets of information that contain summarized details of associated risks of smoking during pregnancy and the potential benefits of quitting smoking (England, 2010, pp. 694-701).

The inclusion of support persons proved beneficial to the nurses to achieve the intended goals and objectives of the quitting program. These people can be a spouse, significant others, other pregnant smokers, friend or collaterals. In this strategy, several activities are executed such as developing a scrapbook about pregnancy, support meetings of peers, and motivational interviews (Owen, McNeill, and Callum, 2008, pp. 728-730). The main assumption of this method bases on the fact that the social system of the pregnant smokers and surrounding people determine the ability of the women quitting smoking. Telephone contacts are conducted by the nurses to the pregnant smokers on a regular basis such as weekly, fortnightly, or bimonthly until the behavior is stopped. The nurses are supposed to use these calls to encourage the pregnant smokers about quitting the behavior as well as ascertaining the personal progress made by the women (England, 2010, pp. 694-701).

There are four clear-cut steps that should be followed by nurses when undertaking the process of stopping smoking. Firstly, precontemplation involves the nurses and the pregnant smokers freely talking about the problem without involving serious issues. In these sessions, the nurses allow the pregnant smokers to talk about their personal experiences and escapades. On the other hand, the nurses can talk about professional cases of reference that can help them stop this behavior (Owen, McNeill, and Callum, 2008, pp. 728-730). Secondly, contemplation encompasses the nurses and pregnant smokers discussing the advantages and disadvantages of quitting the behavior. Last but not least, action involves actualizing the agreed upon strategies to help reduce the frequency of the pregnant women smoking. Lastly, maintenance is also referred to as relapse and involves keeping off the habit or going back to the deviant behavior (England, 2010, pp. 694-701).

Effects of Women Smoking During Pregnancy

Overview

There are various repercussions that emanate from smoking during the gestation period, and they include stillbirth, premature birth, low birth weight, heart failure, brain functioning, and body and lungs (Kristjansson, Fried, and Watkinson, 1989, pp. 11-19). It is important to note that the effects of smoking during pregnancy can be categorized into broad categories as effects on infant growth, long-term effects on growth, effects on cognitive function, effects on activity, attention, and impulsivity, and behavioral and psychological effects. These effects have been analyzed according to the threshold and areas being impacted on the unborn baby (Cnattingius, 2004, pp. 125-140).

Effects on Infant Growth

The growth rate and process of the infant is affected when the mother smokes during pregnancy such that there is a direct correlation between increased smoking and reduction of birth weight. In other words, the more the number of cigarettes a pregnant woman smokes, the more weight the unborn child loses. It has been reported that children born to smoking mothers weigh 150 to 250 grams less as compared to those of non-smoking women. It is important to note that, smoking affects children’s growth at all levels during the gestation period (Eghbalieh, Crinella, Hunt, and Swanson, 2000, pp. 5-13). Children exposed to smoking during pregnancy are reported to have less mass that is fat-free in comparison with the electrical conductivity of the entire body. Exposure to tobacco during pregnancy leads to the children exhibiting reductions in weight and length at birth, and circumference of the head and chest. These effects are more elaborate and pronounced in adult smokers as compared to teenage mothers (Cnattingius, 2004, pp. 125-140).

Long-Term Effects on Growth

It is prudent to assert that the long-term effects of tobacco smoking during pregnancy are not well analyzed. Results from various sources indicate that children exposed to tobacco during pregnancy had material differences in terms of circumferences of the head and chest. Similarly, the exposed children were found to be shorter than their non-exposed counterparts (Makin, Fried, and Watkinson, 1991, pp. 5-12). However, it is reported that the height disparities are curtailed by the weight during birth. There is an inverse relationship between physical attributes of growth and tobacco exposure during pregnancy. There is a positive correlation between the ponderal index and maternal smoking if and only if weight at birth and age of gestation are controlled. This means that children of smoking mothers have higher ponderal index when compared to those of non-smoking mothers. It is essential to deductively conclude that tobacco exposure during pregnancy has negative ramifications on the physique of the infants and children (Cnattingius, 2004, pp. 125-140).

Effects on Cognitive Function

Exposure of minimum magnitude to tobacco during pregnancy affects the development of the central nervous system (CNS). For example, exposure to tobacco during pregnancy makes the children portray increased activities of locomotive aspects. In addition, tendencies of children to be hyperactive emanate from early exposure to tobacco during pregnancy. Furthermore, it has been found out that children exposed to tobacco during pregnancy have a turnover of brain chemicals that is the lower threshold. They also report fluctuations in the hippocampus’ morphology (Eriksson, Ankarberg, and Fredriksson, 2000, pp. 41-48). There are inconsistent reports that have indicated effects on CNS such as outcomes of cognitive development as well as behaviors of the neural system. Children exposed to tobacco during pregnancy tend to exhibit orientation towards hearing of poorer levels, diminished regulation of autonomy, and tremors of increasing intensity as well as startles. There high probabilities of children exposed to tobacco during pregnancy to develop abnormalities of the muscle tone (Cnattingius, 2004, pp. 125-140).

Effects on Activity, Attention, and Impulsivity

There is an increasing direct correlation between exposure to tobacco during pregnancy and increasing levels of activity, lack of attention and impulsivity. Similarly, it has been reported that children exposed to tobacco by their mothers during pregnancy develop increased vulnerability to commit errors such as omission and commission. There is a direct relationship between maternal smoking during gestation and probability that attention deficit hyperactivity disorder (ADHD) (Ananth and Platt, 2004, pp. 12-19). Children exposed to tobacco during pregnancy are always prone to commit errors of omission during examinations such as continuous performance tests (CPT). It is important to note that, these children exposed to tobacco during pregnancy tend to reveal disparities in neuropsychological tests that are aimed to discern the ability of planning and coordinating fine motor skills (Cnattingius, 2004, pp. 125-140).

Behavioral and Psychological Effects150

The problems mentioned above are directly linked to prenatal exposure to tobacco in children. For example, prenatal tobacco exposure has adverse effects on ensuring that behaviors are externalized in terms of opposition, aggression, and overreaction. In this regard, it can be noted that women who smoke during and after pregnancy increase the risks of their children developing problems related to behaviors. On the contrary, if the mothers stopped exposing the children to tobacco after delivery, there are no severe behavioral deficiencies (Persson, Grennert, Gennser, and Kullander, 2013, pp. 33-39). This means that it is highly possible to find children exposed to tobacco during and after pregnancy portraying increased levels of negativity when compared to their counterparts who are not exposed to tobacco after birth. Moreover, it is highly possible for the children of smoking mothers to exhibit tendencies towards malfunctions in terms of opposition, immaturity, and aggression. If these children are observed until puberty stage, there are likely to show discrepancies in conduct, substance abuse and depression as compared to children who were not exposed to tobacco (Cnattingius, 2004, pp. 125-140).

Curtailing Women Smoking During Pregnancy

Several measures can be implemented in order to overcome the addiction of smoking during pregnancy and are related to individual initiatives. They include admitting the addiction, educating, setting up support groups, availing resources, and speakers. It is important to note that, pregnant smokers face escalated instances of being discriminated against as being considered to be deviants (Rebagliato, Florey, and Bolumar, 2015, pp. 531-537). In this regard, smoking women find it difficult to open up to the doctors about their negative behavior. A large proportion of pregnant smokers do not reveal their statuses to medical practitioners and end up. It is essential for the victims to appreciate the fact that, the cessation process begins with the confession about the misbehavior and acceptance for change (Zuckerman, 2012, pp. 73-89).

It is important for the nurses and other social work organizations to engage proactively in ensuring that the pregnant smokers are informed about the significance of quitting smoking. In this regard, the medical institutions and social organizations can arrange sensitisation programs that will raise the level of awareness among pregnant smokers. In these programs, it is imperative for tips about quitting as well as tangible facts about pregnant smoking should be included (Hanke, Sobala, and Kalinka, 2014, pp. 73-87). All stakeholders should engage in partnerships at the national level so as to help pregnant smokers to quit smoking. They can produce written literature such as lines for quitting, specified brochures, printed posters, and sheets about facts. In this regard, the pregnant smokers get access information that will help them avert this dangerous behavior (Zuckerman, 2012, pp. 73-89).

It is important for the associated claimants to set up groups of support that are referred to as buddy systems for pregnant smokers to quit smoking. It has been noted that pregnant smokers assert that emotional and physical support from family members, peers, colleagues, and neighbors. These collective actions is vital in ensuring that all stakeholders provide the necessary support and giving them necessary help to achieve the goal of quitting smokers (Zaren, Lindmark, and Bakketeig, 2000, pp. 118-126). It is important for various speakers to be incorporated in the quitting programs so that they handle issues such as effects, facts and dispelling the lingering myths. These can be experts about public health, survivors of pregnant smoking as well as action initiators with diverse case studies. This will ensure that the smoking cessation program has been fully implemented according to the stated needs and goals (Zuckerman, 2012, pp. 73-89).

Several types of resources can be availed to the pregnant smokers so as to aid in the efforts of achieving smoking cessation. These include telephone resources, print materials, grant resources, publications, and organizations. It is imperative for the pregnant smokers to have unlimited access to the national telephone lines of quitting the habit of smoking. The print materials that should be provided by the health care facilities include those that revolve around tips of quitting smoking (Wikstrom, Stephansson, and Cnattingius, 2010, pp. 1254-1259). They should also describe the benefits of quitting the habit to the pregnant mother as well as the baby. These materials should describe a process to be followed in quitting the habit by setting a specific date for achieving the milestone. Moreover, the printed resources should clearly state the importance of abstinence after childbirth as well as outline the necessary tips for achieving the objective (Zuckerman, 2012, pp. 73-89).

The printed materials can be brochures, booklets, magazines, handouts, newspaper articles, posters, and periodicals. For example, posters can be used to sensitize the pregnant smokers about the appropriate facilities where they can get professional help and guidance about quitting the unnecessary behavior (Plant, 2010, pp. 73-87). The prenatal care providers should be at the front when it comes to developing tear sheets for counseling the pregnant smokers. Grant resources take the form of grantmakers from all over the nation so as to undertake appropriate, necessary steps. A resource center should be established to provide first-hand information regarding resources of the grants (Zuckerman, 2012, pp. 73-89).

Conclusion

Smoking has detrimental effects on the mother and baby as it has been clearly and vividly pointed out. There are several measures that can be implemented in order to ensure that pregnant women do not smoke. The purpose of this essay is to analyze the effects of smoking on women and their children during pregnancy in England. This trend has been worsening with increasing number of women engaging in this heinous and uncalled for behavior.

There are several myths about women smoking during pregnancy such as delivering healthy babies, small babies are cute, addiction, the source of relaxation, the cause of stress on the baby, it is good for the pregnancy, cold turkey is the only way out, and no need for breastfeeding. There are various sources of data that show how this occurrence has trended over the years. Different repercussions emanate from smoking during the gestation period, and they include stillbirth, premature birth, low birth weight, heart failure, brain functioning, and body and lungs. They include admitting the addiction, educating, setting up support groups, availing resources, and speakers.