Practitioners’ Views on Nicotine Replacement Therapy in Pregnancy during Lapse and for Harm Reduction: A Qualitative Study

Ross Thomson, Lisa McDaid, Joanne Emery, Lucy Phillips, Felix Naughton, Sue Cooper, Jane Dyas and Tim Coleman
Additional contact information
Ross Thomson: Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK
Lisa McDaid: School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK
Joanne Emery: School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK
Lucy Phillips: Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK
Felix Naughton: School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK
Sue Cooper: Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK
Jane Dyas: Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK
Tim Coleman: Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK

IJERPH, 2019, vol. 16, issue 23, 1-12

Abstract: Many countries, including the UK, recommend nicotine replacement therapy (NRT) for smoking cessation during pregnancy. However, adherence to NRT is generally low, smoking lapse or relapse is common and using NRT to reduce the harm from the number of cigarettes smoked is only advocated in non-pregnant smokers. Two focus groups were conducted with 13 professionals involved in antenatal stop smoking services (SSS). The data were analysed thematically. Two themes were extracted that describe health professionals’ attitudes towards using NRT either during lapses or to reduce smoking in women who cannot quit (harm reduction). These are presented around a social–ecological framework describing three hierarchical levels of influence within smoking cessation support: (1) Organizational: providing NRT during lapses could be expensive for SSS though harm reduction could result in services helping a wider range of clients. (2) Interpersonal: participants felt using NRT for harm reduction was not compatible with cessation-orientated messages practitioners conveyed to clients. (3) Individual: practitioners’ advice regarding using NRT during smoking lapses varied; many were generally uncomfortable about concurrent smoking and NRT use and had strong reservations about recommending NRT when smoking during all but the briefest lapses. Further evidence is required to guide policy and practice.

Keywords: smoking cessation; pregnancy; nicotine replacement therapy; NRT; stop smoking services; harm reduction (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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