SMOKE FREE MOMS   Dr. Lorenzo Spizzichino   Prevention Department     Ministry of Health         Rome, Italy        Minist...
AcknowledgementI am presenting this work on   behalf ofdr Luca Sbrogiò,dr.ssa Alessandra Schiavinatoand their collaborators
Epidemiological data• Newborns in Italy are 550,000 every year• Mean age at delivery is around 30 years old• the number of...
Effective methods• quit smoking advice by medical doctor or healthpersonnel• individual counselling to quit smoking• cessa...
Smoke free moms: History-2003 Pilot projectconducted in VenetoRegion- 2007 Ministry of Health– CCM programme
Smoke free moms: aimsThe objective of theProgramme is to favour astandardized intervention ofmidwives to help pregnantwome...
Smoke free moms: aimsSpecific objectives:• reduce the number ofwomen who smoke duringpregnancy (<5%)•avoid relapse afterde...
Smoke free moms: Strategy• Production of formative materials• training midwives in counselling to quit    smoking, increas...
SFM: MATERIALS- Counselling guide- Educational materials for tutors/teachers- Forms and data entry for the  monitoring/eva...
TRAINING• 3 days course address to tutors/1-3 days to others• Counselling techniques (theory and practice - role  playing)...
Evaluation of the pilot                project in Veneto Region          A follow-up at two years after delivery          ...
Effectiveness evaluation:                                              follow up 1 year after delivery                    ...
Diffusion of the programmeVeneto                       full participation                        Participation with cancer...
Results of the National        Programme• 20/21 Italian Regions formally adopted the  programme• 4 national courses formin...
Critical aspects• organizational (making permanent the innovation)• scientific:   – How to make the natural cessation rate...
ConclusionsThe programme “Smoke free Moms” is stillongoing, is well accepted by midwives andparents, is feasible and susta...
l.spizzichino@sanita.it
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Poster presentation l spizzichino

  1. 1. SMOKE FREE MOMS Dr. Lorenzo Spizzichino Prevention Department Ministry of Health Rome, Italy Ministero della Salute
  2. 2. AcknowledgementI am presenting this work on behalf ofdr Luca Sbrogiò,dr.ssa Alessandra Schiavinatoand their collaborators
  3. 3. Epidemiological data• Newborns in Italy are 550,000 every year• Mean age at delivery is around 30 years old• the number of young female smokers is around 23%;• the same percentage is smoking at the beginning of pregnancy;• 71% of female smokers quit smoking during pregnancy;• from 70 to 80% relapse after delivery ;• one child over two has at least one parent who smokes.
  4. 4. Effective methods• quit smoking advice by medical doctor or healthpersonnel• individual counselling to quit smoking• cessation group therapy• intervention addressed to pregnant women inorder to quit smoking• intervention addressed to COPD patients in orderto quit smoking The Cochrane Database of Systematic Reviews 2006 Issue 4 Dott. Silvia Minozzi Copyright © 2006 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd. Italian Cochrane Centre
  5. 5. Smoke free moms: History-2003 Pilot projectconducted in VenetoRegion- 2007 Ministry of Health– CCM programme
  6. 6. Smoke free moms: aimsThe objective of theProgramme is to favour astandardized intervention ofmidwives to help pregnantwomen to quit smoking andto follow-up these womenand their families, in thepuerperal period
  7. 7. Smoke free moms: aimsSpecific objectives:• reduce the number ofwomen who smoke duringpregnancy (<5%)•avoid relapse afterdelivery (<50%)
  8. 8. Smoke free moms: Strategy• Production of formative materials• training midwives in counselling to quit smoking, increasing deeper scientific knowledge on women and tobacco issue, specially during pregnancy• Link with special issue dealt by midwives (e.g. breastfeeding)• monitoring and evaluation of the efficacy of the intervention
  9. 9. SFM: MATERIALS- Counselling guide- Educational materials for tutors/teachers- Forms and data entry for the monitoring/evaluation- Educational materials for families (leaflet, reminder, bib, flyers and posters) in 8 different languages- Website www.mammeliberedalfumo.org
  10. 10. TRAINING• 3 days course address to tutors/1-3 days to others• Counselling techniques (theory and practice - role playing)• Tobacco prevention and therapy information• Target: midwives and other health workers (primary health care, paediatricians, gynaecology and obstetrics units, etc.)
  11. 11. Evaluation of the pilot project in Veneto Region A follow-up at two years after delivery conducted on 600 women in 2005-2007 in Veneto Region showed that women and partners who received anti-smoking counselling have better percentage of abstinence compared to a control group.Dr. Luca Sbrogiò - Dipartimento di Prevenzione Az. ULSS19 - Adria
  12. 12. Effectiveness evaluation: follow up 1 year after delivery Sbrogiò, Michieletto, Tagliapietra 2008% of non smokers women at the end of pre-deliverycourse still abstinent one year after delivery 80% 75% 75% 70% 65% 65% 60% Counselling Control90% 87%85%80%75%70% 65%65%60% Counselling (>=3 contacts) Control
  13. 13. Diffusion of the programmeVeneto full participation Participation with cancer league Participation with midwives society Veneto Regione Cohordinator No participation (mateiials)
  14. 14. Results of the National Programme• 20/21 Italian Regions formally adopted the programme• 4 national courses forming 100 tutors who have already trained more 1,500 midwives• The SFM programme is now part of the National Cancer Plan 2010-2012
  15. 15. Critical aspects• organizational (making permanent the innovation)• scientific: – How to make the natural cessation rate permanent, – When to refer parents to a second level of assistance (clinical); – Is pharmacological treatment appropriate and safe during pregnancy and breastfeeding? – Beyond tobacco: towards a global healthy lifestyle.
  16. 16. ConclusionsThe programme “Smoke free Moms” is stillongoing, is well accepted by midwives andparents, is feasible and sustainable.brief counselling by midwives is possible inall settings, especially in out-hospitalpremises.
  17. 17. l.spizzichino@sanita.it

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