Pregnant women are in favor of urine tests for smoking cessation; clinicians express their concern

Up to one-third of smokers with Medicaid deny smoking during pregnancy. A new study reveals that, despite the reservations expressed, low-income patients have a favorable view of the use of urine tests, with consent, to promote smoking cessation during pregnancy.

The study included 19 individual interviews and four focus groups with a total of 40 pregnant or postpartum women with Medicaid who smoked before or during pregnancy and 20 interviews with clinicians.

The researchers collected patient urine samples with the help of a test strip system that allows the semi-quantitative detection of cotinine, a major nicotine by-product.

The majority of women surveyed (89%) were strongly in favor of smoking during pregnancy, but some feared the consequences of a positive cotinine test.

Specifically, they worried about their clinician's reaction, the potential violation of their privacy and the involvement of government entities such as child protection services.

The women indicated that they would be more open to the test if clinicians described how the test could help them and help their pregnancy.

The majority of clinicians (more than 80%) feared that urine tests would affect their relationship with patients.

The authors call for research on the feasibility of a consensus test of urine tests on tobacco use in a clinical setting If an increased number of tests allows more patients to obtain support and advice on smoking cessation, the public health benefits could be enormous.

Explore further:
Nicotine exposure during pregnancy almost twice as high as reported

More information:
Prenatal Tobacco Point-of-Care Screening and Clinical Relationships, Aisha Bobb-Semple, MD, et al.