Continuous quality improvement study: Smoking cessation in pregnant women

Introduction: Smoking during pregnancy has serious consequences for maternal and child health, associated with complications in pregnancy and serious long-term health implications. In Portugal, 27.7% of women were smoking before becoming pregnant. Pregnancy monitoring appointments provide multiple opportunities for counseling, at a stage when the woman is more open to changing her behavior. Goals: This study aimed to improve the quality of the clinical records of the smoking cessation counseling intervention with the aim of carrying out one or more brief or very brief approaches in at least 40% of pregnant smokers aged 15 or over. Methods: Our study population were all the pregnant women in 2023 with at least one medical or nursing maternal appointment in the 1st trimester of pregnancy. Health professionals from our family health units were recruited through several phases to implement professional strategies to support pregnant women in the stop smoking process. Physician Education: A preliminary evaluation was carried out and the results presented to health professionals (doctors, nurses). During the implementation of the project (January-December 2023), a mid-term evaluation was carried out and the results presented to all those involved. Monthly reminders were created for health professionals. Patient Education Campaign: The range of interventions offered to promote smoking cessation in pregnancy were individual strategies which include: provision of advice and counselling, using various tools (written/ electronic resources), motivational interviewing and encouragement. Monitoring: The number of pregnant women who received smoking cessation interventions throughout the duration of the study was recorded. After analysis and intervention, the objectives initially proposed were achieved. Conclusion: Smoking cessation interventions in pregnancy needs to be implemented in all primary care settings, in order to reduce the maternal and fetal risks.