Article Review
Introduction
Smoking is the most common drug dependence during pregnancy, and it is associated with a plethora of problems, which may encompass; fetal growth retardation, premature delivery, and low birth weight. In light with this, maternal smoking is not only harmful during pregnancy, but has a long term impact on the baby after birth. Over the decades, public health officials and the government have been in the fore front in the pursuit to control or correct the issue of smoking during pregnancy. Moreover, different medical researches on smoking during pregnancy have been carried out, and they have contributed monumentally to the support of claims about fetal and infant health risks, accompanied by smoking.
Similarly, various pregnancy advice articles have been written, and public health campaigns have been done to translate the technical scientific information gathered for practical use. In line with this, different arguments have been raised concerning various researches done and literatures written on the issue. This paper on the other hand, will foreground the main argument colligated to smoking during pregnancy as depicted in ten different scholarly articles. In tandem to this, it will critically reflect and review the articles, and define the controversies and inconsistencies within the articles.
Principal Arguments
It is perceptible that smoking during pregnancy has inauspicious outcome, and this is in agreement with all the articles, since there is no article that supports smoking during pregnancy. In conjunction to this, there are different health effects highlighted, and Agrawal et al. (2009) assert that maternal smoking during pregnancy is typically affiliated with decrease birth weight, and low scholastic achievement. In addition to this, Mendelsohn (2010) affirm that smoking in pregnancy catapults the risks of still birth, preterm delivery (giving birth to the baby before the right time), spontaneous miscarriage or abortion, or even perinatal death. Further, children born to smoking mothers may experience reduced lung functioning, increased risk of respiratory illnesses, brain tumor, childhood cancer, sudden infant death syndrome (SIDs), hearing problems and even asthma (Mendelsohn, 2010; Mohsin, Bauman and Forero, 2010). Exposure of the unborn baby to heavy smoking may also increase the risk of nicotine addiction in adulthood (Agrawal et al. 2009; Mendelsohn, 2010), and affect the age of menarche in the girl child (Shrestha, Nohr, Bech, Ramalu-Hansen & Olsen, 2010).
In relation to this, the various efforts put in place in order to optimize smoking surcease during pregnancy, have been faced with a lot of difficulties. Lack of education and awareness, are among the key facets that hinders the cessation process (Ergin, Hassoy, Tanik & Aslan, 2010; BMC Public Health, 2005; Passey, Este & Sanson-Fisher, 2012). Besides, it is also proven that women experience more difficulty in quitting than men, thence establishing hurdles in the whole quitting process (Mendelsohn, 2010; Lawrence, Aveyard, Evans & Cheng, 2002). Mohsin, Bauman and Forero (2010) support this through their research, which proved that the decline or reduction of smoking in pregnancy was highest in socioeconomic group and least in teenage girls and rural mothers, ascribed to poor educational background. Other factors that also posed as a barrier to quitting smoking encompassed, fear of weight gain, stress, withdrawal symptoms, fear of failure (Mendelsohn, 2010), repeated social and environmental exposure to smoking, and poor preference for quitting support (Bryant, Bonevski, Paul, O’Brien & Oakes, 2011).
In line with this, some of the articles also address the possible ways to increase smoking cessation among pregnant women. Tentatively, they also high spot the positive effects of the entire process, issuing practicable consideration and prepositions. Hotham (2006) avows that despite the use of nicotine patches to enhance smoking cessation is highly applicable, the idea may not work effectively on pregnant women. Mendelsohn (2010) also champions for medication intervention like pharmacotherapy, nicotine replacement therapy and even counseling.
Critical Reflections
All the articles have expressed the fundamental idea of the negative effects of smoking in pregnancy. However, there is some repugnance exhibited in each article. Hotham (2006) corroborates that the use of nicotine patches is not a reasonable step in enhancing smoking cessation among pregnant women. However, Hotham (2006) never gives clear inference in the article, since the research carried out is faced with mixed setbacks-low involvement participation and high withdrawal rates- moreover, Hotham (2006) clearly states in the article that some of the participants were only offered counseling, yet the key objective was to determine the use of nicotine to enhance smoking cessation, thence, this facets tend to render the article quite inadequate, when it comes to addressing smoking in pregnancy.
Similarly, most of researches portrayed in the articles, are carried out in several sampled communities, and then generalized deductions made. Mohsin and Bauman (2005) declare that smoking in pregnancy has been declining over the years, ascribing to the research done in New South Wales, Australia. As well, Bryant et al. (2011) give a detailed account of barriers to quitting smoking among disadvantaged Australian smokers-doubting ability to quit, poor knowledge of available quit support, fearing of gaining weight and beliefs that smoking alleviates stress. Mohsin, Bauman and Forero (2010) also focus more in socioeconomic correlations and smoking in pregnancy trends, in New South Wales, Australia, while Ergin et al. (2010) checks the socioeconomic determinants for smoking during pregnancy in Turkey. The entailments made in these articles are based from given regions, thus making it unpleasant to generalize that the same results can be applied in other regions.
Unlike the other articles, Mendelsohn (2010) concentrates more on women who smoke. He gives a lot of details on the effects of smoking on health, the barriers to quitting, and the possible mitigation measures to encourage one to quit smoking. Nevertheless, he gives a notable report on smoking in pregnancy, avowing that smoking reduces milk production. In conjunction to this, some articles also provide postnatal account of smoking in pregnancy, while others do not. Agrawal et al. (2009) describes the significant postnatal effects of smoking in pregnancy, which encompass; Low birth weight, Cognitive dysfunction, impaired learning, and high tendency of the offspring to smoke at a later age. Shrestha et al. (2010) also talks of the effect of smoking on the age of menarche in girls. In addition, some articles have also combined both the effects of smoking and alcohol on pregnant mothers, which are clearly depicted by Shrestha et al. (2010), in their explanation of effect of smoking and alcohol on the age of menarche in girls, and this makes the article a fascinating piece of literature for reading, since it offers a wide range of knowledge.
The Need for More Research
It is evident that the articles offer a quality provision of knowledge on smoking in pregnancy, through pin pointing the associated health effects, ways to enhance smoking cessation and the barriers to quitting. Nonetheless, there is the need for more research to be done pertaining to this area (smoking in pregnancy). A varied target group should be taken into consideration, and more regions included in research, in order to establish clear and non bias results, which according to Rubin and Babbie (2011) such preferable and accurate results can be achieved through proper randomization, and assigning willing but not forced research participants to manageable groups.
Apart from tobacco use, smoking of marijuana should also be researched upon and articles written. Although there are few cases of marijuana smoking women, but its effects on health are equally detrimental. Marijuana smoking on pregnancy can result to several defects in a newborn child: an altered response to visual stimuli, an increased tremulousness, and a dysfunctional central nervous system (CNS), characterized by high-pitched cry (Ricci & Kyle, 2009). Excess smoking of marijuana, may also lead to an alteration in the blood pressure, and this may endanger fetal life, together with this, other effects similar to effects produced by excessive use of nicotine, may also be experienced (Ricci & Kyle, 2009).
More information on lack of information as a facet that inhibits cessation of smoking in pregnancy should also be investigated. With the technological progress, in the 21st century, it is believed that social and communication networks are reachable to almost everyone in the world, and each person can acquire information concerning negative effects of smoking; hence it is extremely rhetorical for smoking victims to claim that they are not informed (Ricci & Kyle, 2009). This is also largely enforced by the fact the cigarettes packs also contain warning labels that clearly state that cigarettes smoking is harmful to someone’s health.
Paternal smoking during pregnancy should also be well articulated, since they can also lead to severe postnatal health effects, which can involve reduced physical development, decrement in cognition and behavior development, and increased risk for childhood cancer (Boyle, Gray, Henningfield, Seffrin & Zatonski, 2010). Respiratory problems and sudden infant death syndrome (SIDs) are as well common, attributed to paternal smoking (Boyle et al., 2010).
Conclusion
Concisely, the articles provide brilliant information on the health effects of smoking in pregnancy, its prevalence, the barriers to quitting and the possible mitigation measures, which in turn, make the articles engrossing and worth reading. Conventionally, not all information about effects of paternal smoking, are discussed, and the authors do not suggest ways forward on how to spread the enlightenment concerning dangers of smoking in pregnancy. However, when more research is done, precise policies put in place and adequate campaigns against smoking in pregnancy done, then many lives can be saved.
References
Agrawal, A. et al. (2009). The Effects of Maternal Smoking during Pregnancy on Offspring Outcomes. Retrieved from http://dx.doi.org.ezproxy.csu.edu.au/10.1016/j.ypmed.2009.12.009
Boyle, P., Gray, N., Henningfield, J., Seffrin, J. & Zatonski, W. (Eds.). (2010). Tobacco: Science, Policy and Public Health (2nd Ed.). New York, NY: Oxford University Press.
Bryant, J., Bonevski, B., Paul, C., O’Brien, J. & Oakes, W. (2011). Developing Cessation Interventions for the Social and Community Service Setting: A Qualitative Study of Barriers To Quitting Among Disadvantaged Australian Smokers. BMC Public Health 2011, 11:493. doi:10.1186/1471-2458-11-493.
Ergin, I., Hassoy, H., Tanik, A. F & Aslan, G. (2010). Maternal Age, Education Level and Migration: Socioeconomic Determinants for Smoking During Pregnancy in A Field Study from Turkey. BMC Public Health 2010, 10:325. doi:10.1186/1471-2458-10-325.
Hotham, D. E. (2006). Smoking Cessation; Smoking Cessation by Use of Nicotine Patches May Not Be Useful Strategy for Pregnant Women. Science Letter.
Lawrence, T., Aveyard, P., Evans, O. & Cheng, K. k. (2002). A Cluster Randomised Controlled Trial of Smoking Cessation in Pregnant Women Comparing Interventions Based on The Transtheoretical (Stages of Change) Model To Standard Care. Tob Control 2003;12:168-177. doi:10.1136/tc.12.2.168.
Mendelsohn, C. (2010). Women Who Smoke: A Review of the Evidence. Australian Family Physicians,39, 403-407.
Mohsin, M., Bauman, E. A. & Forero, R. (2010). Socioeconomic Correlates and Trends in Smoking in Pregnancy in New South Wales, Australia. J Epidemiol Community Health 2011;65:727-732. doi:10.1136/jech.2009.104232
Mohsin, M., Bauman, E. A. (2005). Socio-Demographic Factors Associated With Smoking And Smoking Cessation Among 426,344 Pregnant Women In New South Wales, Australia. BMC Public Health. 2005; 5: 138. doi: 10.1186/1471-2458-5-138
Passey, E. M., Este, D. A. C. & Sanson-Fisher, W. R. (2012). Knowledge, Attitudes and Other Factors Associated with Assessment of Tobacco Smoking Among Pregnant Aboriginal Women By Health Care Providers: A Cross-Sectional Survey. BMC Public Health 2012, 12:165. doi:10.1186/1471-2458-12-165
Ricci, S. S. & Kyle, T. (2009). Maternity and Pediatric Nursing. Philadelphia, PA: Wolters Kluwer Health/Lippincott & Wilkins.
Rubin, A. & Babbie, R. E. (2011). Research Methods for Social Work (7th Ed.). Belmont, CA: Cengage Learning.
Shrestha, A., Nohr, A. E., Bech, H. B., Ramalu-Hansen, H. C. & Olsen, J. (2010). Smoking and Alcohol Use during Pregnancy and Age of Menarche in Daughters.
