Developing guidelines for smoking cessation interventions for pregnant adolescents

Adolescent Pregnancy and Smoking in West Virginia: Pregnancy Risk Assessment Monitoring System (PRAMS) 2005-2010

Objective The purpose of this study was to examine the association between prenatal smoking and small for gestational age (SGA) infants among adolescent women in West Virginia, taking into account sociodemographic and health-related factors. Methods Secondary data analysis was conducted using the 2005-2010 West Virginia Pregnancy Risk Assessment and Monitoring Systems weighted dataset. The study population using complete case analysis procedure consisted of 886 adolescent women ages 19 and younger who delivered a live singleton infant in West Virginia. Results The prevalence of smoking among adolescents during the last 3 months of pregnancy was 67 %. Nearly a quarter (22.0 %) of the adolescents gave birth to SGA infants. Results from the logistic regression analysis showed that after controlling for sociodemographic and health-related variables, adolescents who smoked during the last 3 months of pregnancy were more likely to have SGA infants than those who did not smoke during the last 3 months of pregnancy (OR = 1.86, 95 % CI 1.06-3.27, P = 0.0307). Conclusion This study highlights the importance of recognizing that prenatal smoking is an issue among West Virginia adolescents and the need for evidence-based, culturally, and developmentally appropriate interventions for this Appalachian population.

Development of a multidimensional measure of tobacco dependence in adolescence

The objective of this research was to develop a multidimensional measure of tobacco dependence, sensitive to signs of incipient dependence and relevant to adolescents. A cross-sectional survey was conducted of students attending randomly selected high schools in two regions of British Columbia, Canada. Of the 3280 adolescents who completed the survey, 17% (n=562) indicated that they had smoked at least once in the month preceding the survey and were classified as "smokers." Ninety-one percent of the smokers (n=513) completed all or most of the items and comprised the sample for the analysis. The survey included a number of items related to smoking status and nicotine dependence, including the newly developed Dimensions of Tobacco-Dependence Scale (DTDS), a 54-item multidimensional measure of tobacco dependence. Exploratory factor analyses using MINRES was used to examine the dimensions of the DTDS. The measure was found to include four dimensions: social reinforcement, emotional reinforcement, sensory reinforcement, and physical reinforcement. All subscales had adequate reliability (Cronbach's alpha coefficients >.70).

Tabagismo e suas peculiaridades durante a gestação: uma revisão crítica

A gestação é uma ocasião especial para a promoção da cessação do tabagismo. A preocupação com a saúde do feto gera uma motivação extraordinária na gestante. Os resultados e a relação custo-efetividade das intervenções são melhores neste grupo do que na população em geral. Os ganhos extrapolam os benefícios à saúde da mulher, pois permitem também o desenvolvimento de um feto mais saudável. O conhecimento das peculiaridades do tabagismo durante a gestação é fundamental para uma abordagem direcionada e com maior probabilidade de sucesso. Este trabalho de revisão tem o objetivo de ressaltar a extensão dos malefícios do fumo, tanto para a mulher gestante quanto para seu feto, e estimular o uso de técnicas apropriadas para a suspensão do tabagismo nesta população.

Health risks and psychosocial outcomes of early childbearing: a review of the literature

This article presents a review of the literature on the obstetric, medical, and neonatal health risks as well as psychosocial outcomes associated with early childbearing. An important concern in adolescent pregnancies is the increased risk for infant morbidity and mortality as a result of higher incidence of preterm births and low-birthweight infants. Implications for prenatal and postpartum nursing care are discussed. Promising new models to improve care of young mothers and their children, such as home visitation by public health nurses, are presented and features of successful intervention programs outlined.