Women and smoking: patterns, health effects, and treatments

Tobacco use remains the number one cause of preventable death among women in the United States. Of particular concern to obstetricians and gynecologists is the morbidity caused by tobacco use and by exposure to secondhand smoke among women of childbearing age, pregnant women, and their newborns. Women who smoke have lower fertility rates and are more likely to experience negative side effects from oral contraceptives. Pregnant women who smoke are more likely to suffer miscarriages and to have low birth weight and preterm babies, and infants with sudden infant death syndrome. Over one of every four women aged 18 to 44 smoke in the U.S. Unfortunately, at least 14% of women smoke during pregnancy. The good news is that research shows that tobacco treatment interventions by health care providers can increase the number of patients who successfully quit. The Agency for Health Care Policy and Research developed recommendations and guidelines to assist health care providers to integrate a tobacco treatment intervention into an office setting. It is recommended that every physician 1) ask patients about their tobacco use; 2) advise them to stop using tobacco; 3) assist patients interested in cessation efforts; and 4) arrange appropriate follow-up.