IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i13p4770-d379524.html
   My bibliography  Save this article

Intensive Behavioural and Pharmacological Treatment for Tobacco Dependence in Pregnant Women with Complex Psychosocial Challenges: A Case Report

Author

Listed:
  • Melissa A. Jackson

    (Hunter New England Health Local Health District, Newcastle, New South Wales 2300, Australia)

  • Amanda L. Brown

    (Hunter New England Health Local Health District, Newcastle, New South Wales 2300, Australia)

  • Amanda L. Baker

    (School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia)

  • Adrian J. Dunlop

    (Hunter New England Health Local Health District, Newcastle, New South Wales 2300, Australia)

  • Angela Dunford

    (John Hunter Hospital, Hunter New England Health Local Health District, New Lambton, New South Wales 2305, Australia)

  • Gillian S. Gould

    (School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia)

Abstract

Up to 95% of women who use other substances also smoke tobacco during pregnancy. Challenging psychosocial circumstances and other barriers that contribute to high levels of tobacco dependence result in few quitting successfully. This case report describes the treatment of a highly tobacco dependent 34-year-old pregnant woman with a history of recent substance use, mental illness and trauma, enrolled in the Incentives to Quit Tobacco in Pregnancy program. Heavy smoking, both during the day and overnight, was reported. An extensive history of quit attempts, as well as a strong desire to cease tobacco use during pregnancy, was also noted. Treatment utilising extensive behavioural supports, including financial incentives for carbon monoxide verified abstinence and telephone-based counselling, in combination with nicotine replacement therapy (NRT), was offered to assist cessation. Excellent uptake and adherence to all aspects of treatment saw tobacco cessation achieved and maintained for 24 weeks while on the program. NRT used at doses well above those recommended for pregnancy was required to alleviate strong withdrawal symptoms and maintain abstinence. Daily monitoring of carbon monoxide, financial incentives for continued abstinence and regular phone support were critical to maintaining motivation and preventing relapse to smoking. Post-program relapse to smoking did occur, as is common, and highlights the need for longer-term intensive support for pregnant women with complex behavioural and social problems. Given the prevalence of tobacco smoking in such populations, long-term harm reduction treatment models using extensive behavioural support in combination with NRT should be considered for inclusion in current smoking cessation guidelines.

Suggested Citation

  • Melissa A. Jackson & Amanda L. Brown & Amanda L. Baker & Adrian J. Dunlop & Angela Dunford & Gillian S. Gould, 2020. "Intensive Behavioural and Pharmacological Treatment for Tobacco Dependence in Pregnant Women with Complex Psychosocial Challenges: A Case Report," IJERPH, MDPI, vol. 17(13), pages 1-8, July.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:13:p:4770-:d:379524
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/13/4770/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/17/13/4770/
    Download Restriction: no
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:13:p:4770-:d:379524. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.