Pregnancy‐related changes in tobacco, alcohol and cannabis use reported by antenatal patients at two public hospitals in South Australia

Hotham, Elizabeth; Ali, Robert; White, Jason M.; Robinson, Jeffrey S.

doi:10.1111/j.1479-828x.2008.00827.x

Cited by 40 publications

(54 citation statements)

References 18 publications

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“…Given public health messages related to fetal damage and smoking and the limited social acceptability of smoking while pregnant, it is unlikely that nicotine use would have been preferentially disclosed and this predominance is likely to be authentic, although in marked contrast to earlier research with this population, 54 in which only 66% of substance users were using nicotine.…”

Section: The Study Samplementioning

confidence: 53%

“…Participants in the earlier research 54 were, by design, all women presenting for their first antenatal visit.…”

Section: The Study Samplementioning

confidence: 99%

“…Sample size calculations were informed by findings for nicotine use in an earlier study in the same population, 54 in which, of 748 women, 209 used at least 1 substance; of the 209 substance users, 138 (66%) were nicotine users. For this study it was estimated by simulation that a total sample size of 104 participants would allow for the calculation of weighted kappa between the ASSIST V3.0 and the RTQ with a SE of r0.10.…”

Section: Sample Size and Statistical Analysesmentioning

confidence: 99%

“…Investigation was focussed on nicotine, alcohol, and cannabis, previously shown to be the substances most used in the study population, with nicotine use being the highest. 54 …”

mentioning

confidence: 97%

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Investigation of the Alcohol, Smoking, and Substance Involvement Screening Test (the ASSIST) Version 3.0 in Pregnancy

Hotham

Ali

White

et al. 2013

Addictive Disorders &Amp; Their Treatment

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Objectives:To investigate the utility of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Version (V) 3.0 for identifying substance use disorders in pregnancy. Methods:ASSIST V3.0's performance was assessed, focussed on nicotine, alcohol, and cannabis, using a 2-pronged harm categorization: risk to the woman as an individual and risk to the fetus. For the former, risk levels concordant with general population cut-points were utilized. A total of 104 substance users in an Australian public maternity hospital were identified by case-note audit. The ASSIST V3.0 scores were appraised against the scores for established tools-tobacco: the Revised Fagerstrom Tolerance Questionnaire, alcohol: the tolerance, annoyed, cut down, eye-opener, and cannabis: the Timeline FollowBack. Results:Kappa analyses of Specific Substance Involvement Scores for ASSIST V3.0 did not support changing cutpoints for the woman as an individual; however, receiver operating characteristics curves delineated an Specific Substance Involvement Scores of 4 as indicative of fetal risk for both alcohol and cannabis. All nicotine users (98 of the 104 participants) were ''at high risk''; hence a cut-point indicative of fetal risk for nicotine could not be determined. Conclusions:The role of the ASSIST V3.0 is uncertain for this population. Given the predominance of nicotine use, nicotine use screening could be the primary focus, with follow-up screening for alcohol and other substances if tobacco use were identified; there may be a place for a restructured ASSIST in that context. Positive screening results should be followed by ongoing counseling support throughout pregnancy, with the intensity dictated by the severity of use.

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Section: The Study Samplementioning

confidence: 53%

“…Participants in the earlier research 54 were, by design, all women presenting for their first antenatal visit.…”

Section: The Study Samplementioning

confidence: 99%

Section: Sample Size and Statistical Analysesmentioning

confidence: 99%

“…Investigation was focussed on nicotine, alcohol, and cannabis, previously shown to be the substances most used in the study population, with nicotine use being the highest. 54 …”

mentioning

confidence: 97%

See 2 more Smart Citations

Investigation of the Alcohol, Smoking, and Substance Involvement Screening Test (the ASSIST) Version 3.0 in Pregnancy

Hotham

Ali

White

et al. 2013

Addictive Disorders &Amp; Their Treatment

Self Cite

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“…During the first trimester of pregnancy, binge drinking was reported by 10.1% of pregnant women (SAMHSA, 2011). This research suggests that most women reduce alcohol consumption during pregnancy; however, there are still some women who drink alcohol at heavy or binge drinking levels during pregnancy (Burns et al, 2006;Hotham et al, 2008;Maloney et al, 2011;Stade et al, 2009). These studies suggest that women in developed countries are consuming more alcohol than a decade ago and that many are able to reduce or abstain from alcohol while pregnant; however, some pregnant women are unable to curtail their alcohol consumption (Burns et al, 2006;Hotham et al, 2008;Maloney et al, 2011;Stade et al, 2009).…”

mentioning

confidence: 92%

Hospital Admissions for Alcohol Use Disorders Before, During, and After Pregnancy: A Study Based on Linked Population Data in New South Wales, Australia

Bonello

Burns

et al. 2013

Alcoholism Clin & Exp Res

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Psychosocial interventions for supporting women to stop smoking in pregnancy

Chamberlain

O’Mara-Eves

Oliver

et al. 2013

Cochrane Database of Systematic Reviews

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Background Tobacco smoking in pregnancy remains one of the few preventable factors associated with complications in pregnancy, stillbirth, low birthweight and preterm birth and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and increasing in low- to middle-income countries. Objectives To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. Search methods In this fifth update, we searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (1 March 2013), checked reference lists of retrieved studies and contacted trial authors to locate additional unpublished data. Selection criteria Randomised controlled trials, cluster-randomised trials, randomised cross-over trials, and quasi-randomised controlled trials (with allocation by maternal birth date or hospital record number) of psychosocial smoking cessation interventions during pregnancy. Data collection and analysis Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, and subgroup analyses and sensitivity analysis were conducted in SPSS. Main results Eighty-six trials were included in this updated review, with 77 trials (involving over 29,000 women) providing data on smoking abstinence in late pregnancy. In separate comparisons, counselling interventions demonstrated a significant effect compared with usual care (27 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.75), and a borderline effect compared with less intensive interventions (16 studies; average RR 1.35, 95% CI 1.00 to 1.82). However, a significant effect was only seen in subsets where counselling was provided in conjunction with other strategies. It was unclear whether any type of counselling strategy is more effective than others (one study; RR 1.15, 95% CI 0.86 to 1.53). In studies comparing counselling and usual care (the largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy (eight studies; average RR 1.06, 95% CI 0.93 to 1.21). However, a clear effect was seen in smoking abstinence at zero to five months postpartum (10 studies; average RR 1.76, 95% CI 1.05 to 2.95), a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77), and a significant effect at 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), but not in the longer term. In other comparisons, the effect was not significantly different from the null effect for most secondary outcomes, but sample sizes were small. Incentive-based interventions had the largest effect size compared with a less intensive intervention (one study; RR 3.64, 95% CI 1.84 to 7.23) and an alternative intervention (one study; RR 4.05, 95% CI 1.48 to 11.11). Feedback interventions demonstrated a significa...

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Pregnancy‐related changes in tobacco, alcohol and cannabis use reported by antenatal patients at two public hospitals in South Australia

Cited by 40 publications

References 18 publications

Investigation of the Alcohol, Smoking, and Substance Involvement Screening Test (the ASSIST) Version 3.0 in Pregnancy

Investigation of the Alcohol, Smoking, and Substance Involvement Screening Test (the ASSIST) Version 3.0 in Pregnancy

Hospital Admissions for Alcohol Use Disorders Before, During, and After Pregnancy: A Study Based on Linked Population Data in New South Wales, Australia

Psychosocial interventions for supporting women to stop smoking in pregnancy

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