Ask about smoking:  Use question that increases self-disclosure of smoking (Mullen, 1991)

            I smoke regularly now, about the same as before finding out I was pregnant.

            I currently do not smoke cigarettes.

Advise to quit:  Provide clear advice that quitting smoking is optimal.  Praise women for cutting down, but still make it clear that quitting is the ideal.

 

Praise women who have quit.

 

Assess readiness to quit.  For those still smoking, determine how much woman wants to quit smoking.  Ask about considering quitting in next 6 months and then if planning to quit in next 30 days.

 

Assist with quitting:  Help women who are ready to quit set a reasonable quit date, plan for barriers to quitting, help build confidence, and build cessation skills.

 

Provide supplementary materials.

 

Discuss the possibility of using pharmacotherapy (nicotine replacement therapy) with women who are unable to quit on their own.

 

For women who are not ready to quit, help build motivation and confidence.

 

For women who have quit, discuss likelihood of smoking resumption postpartum. Build motivation and confidence to stay smoke free.

 

Arrange follow-up:  Arrange a follow-up visit to discuss how the quit attempt is going.