A significant knowledge gap about smoking cessation practices among perinatal substance abuse staff at a single center means pregnant women are often not being counseled about the dangers of tobacco and encouraged to quit, new research suggests.
Perinatal substance abuse counselors from the Johns Hopkins Center for Addiction and Pregnancy in Baltimore, Maryland, fared significantly worse than substance abuse staff who worked in Veteran's Administration hospital centers, other hospital-based centers, and community counseling centers throughout the United States.
"We found that they had much less knowledge about smoking cessation practices, and they also were more likely to have negative attitudes about their ability to get these women to stop smoking," senior author Margaret Chisolm, MD, from the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine, in Baltimore, told Medscape Medical News.
The findings were presented here at the American Society of Addiction Medicine (ASAM) 45th Annual Medical-Scientific Conference.
More Harmful Than Illicit Drugs
Nearly 21% of reproductive-age women in the United States smoke cigarettes, and about 13% continue to smoke during pregnancy. This percentage is as high as 90% among pregnant women with substance use disorders, Dr. Chisolm said.
"When I started working here in 2006, this issue literally hit me in the face. These pregnant women who are in our drug abuse program would smoke outside the hospital in between their group sessions, and things like that, so I wanted to know why we were not addressing this in our program, especially since smoking is the leading modifiable risk factor for pregnancy-related morbidity and mortality," she said.
"Smoking is as harmful, if not more harmful, than most of the illicit drugs that pregnant women use," Dr. Chisolm added.
In the study, Dr. Chisolm used the Smoking Knowledge, Attitudes, and Practices (S-KAP) Instrument to compare the knowledge, attitudes, and practices among the 41 perinatal substance abuse staff at her institution with the knowledge, attitudes, and practices among 335 general substance abuse treatment staff from 11 other institutions.
The S-KAP Instrument was developed by Kevin L. Delucchi, PhD, and colleagues from the University of California, San Francisco, and published in the Journal of Drug Issues.
The instrument elicits staff knowledge about the risks of smoking, attitudes toward treating...Read more..
The International Journal of COPD has published the review, “The role of microparticles in chronic obstructive pulmonary disease”.
As corresponding author Dr. Kubo says “Endothelial damage is believed to affect the pathophysiology of COPD, however, the influence of COPD exacerbation on the endothelium is not clearly understood. In this manuscript, we evaluated the influence of exacerbation on the endothelium by measuring circulating endothelial microparticles (EMPs), which are shed membrane vesicles in circulating blood that originate from activated or injured endothelium.”
Dr. Kubo continues “Several EMPs were significantly increased even at stable condition in COPD patients, but further increased during exacerbation. The increased EMPs were originated mainly from pulmonary capillary endothelial cells, suggesting pulmonary capillary is the main site suffered from exacerbation. Because circulating E-selectin EMPs increased in COPD patients who frequently underwent exacerbation, monitoring of EMP numbers is useful for evaluating endothelial damage in COPD patients and higher E-selectin EMP levels may predict the patients who are susceptible to exacerbation.”
As Dr. Richard Russell, Editor-in-Chief, explains “This is one of the first papers published on this subject. It is good science which is clear and understandable. The potential of the micro-particles both in the aetiology and treatment (even prevention) of COPD is massive.”
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The International Journal of COPD is an international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self-management protocols. This journal is directed at specialists and healthcare...Read more..