Smoking cessation counseling practices: A survey of Alabama obstetrician-gynecologists

Background. Minimal interventions delivered by obstetrician-gynecologists (OB-GYNs) to their pregnant patients who smoke could result in a substantial decrease in smoking during pregnancy. We examined performance and motivation levels of Alabama OB-GYNs for engaging in clinical practices based on National Cancer Institute (NCI) guidelines. Methods. Questionnaires assessing attitudes, intentions, and behaviors specified by the NCI's "4-A" model (ask, advise, assist, and arrange follow-up) were mailed to all OB-GYNs licensed in Alabama. Results. A total of 130 physicians completed the questionnaire. Nearly all reported that they ask (93%) and advise (90%) their patients who smoke to quit; however, significantly fewer reported that they assist (28%) or arrange follow-up (24%) with their pregnant patients. Conclusions. Interventions are needed to motivate, support, and guide OB-GYN physicians to assist and follow-up with their pregnant patients who smoke.