If pregnancy is a crucial moment to quit smoking, for the health of the future mother and that of her child, one in two smokers in France fail to quit, sometimes complicated by social difficulties, unequal access to support and a lack of information.
“My partner told me: you will never be able to stop smoking! My reward was to taunt him…” laughs Fanny, mother of a newborn, Telio, who like many pregnant women, has tried to drastically reduce her tobacco consumption.
“I had already tried before, but it had not been conclusive. I did not want to poison this child for whom I had been waiting for 11 years,” said, five days after giving birth, this 42-year-old Lyonnaise, followed at the Woman Mother Child hospital.
Thanks to the help of a tobacco specialist midwife, she ist “down to 15 cigarettes, then six, five, four, three…” “I was proud. The last two, at the beginning of the afternoon and before bed, stuck”she explains to AFP in the run-up to the No Tobacco Month campaign in November.
“Pregnancy is a very interesting lever but the most dependent women cannot stop. The challenge is not to make them feel guilty but to support them”, says David Saint-Vincent, psychologist at Rouen University Hospital.
“Fear of being lacking”
The consequences can be serious for 85,000 children born each year to mothers who smoke until the 3rd trimester (12% of women): “Prematurity, reduced birth weight, increased risks of addiction and smoking, psychiatric disorders, obesity and asthma…”, recalls the Ministry of Health.
However, weaning yourself, even at the end of pregnancy, will have “a profit”, explains Marie Van der Schueren, medical tobacconist at CHU de Caen. “The means to stop exist, we still need to know how to prescribe them and use them.”
Those who cannot do it at the start of pregnancy “have a physical dependence on nicotine”, indicates Maud Catherine Barral, the midwife who followed Fanny. “We give them nicotine substitutes: a patch combined with gum, lozenges, an inhaler, a spray.”
Reimbursed on prescription and without a ceiling by Health Insurance, these substitutes can be prescribed by doctors, nurses, midwives or physiotherapists.
Smokers have “fear of being lacking” more “when we found the right dose, they are very surprised to feel so good without smoking” reports Corinne Adler, tobacco midwife at the Parisian Bluets maternity ward.
“Nicotine does not cause illness, unlike burning cigarettes which releases 4,000 toxic compounds. But it causes dependence: to wean the woman gently, we must not hesitate to give her enough nicotine. Then it we will have to help him wean himself off the substitutes”, she said.
“Young, precarious mothers”
“According to scientific data obtained in a French study, succeeding in making at least three repeated quits for a week, thanks to tobacco monitoring, rather than continuing to smoke a few cigarettes per day, makes it possible to significantly increase the baby’s birth weightreports Doctor Anne-Laurence Le Faou, addictologist at the Parisian Pompidou hospital.
But support is not always accessible to “young, precarious mothers, in socio-economic difficulty”, emphasizes Dr Van der Schueren.
“For some, it is already difficult to quit alcohol… quitting tobacco is experienced as a double punishment. Whereas to optimize things, we should quit both,” she continues.
“Financial rewards in the form of vouchers could work to help wean pregnant women with social difficulties,” pleads Dr Le Faou.
Each woman faced with this addiction celebrates her victories in her own way, according to Ms. Barral: “They will draw, paint, knit, take a walk, breathe for 10 minutes.” “A patient of Brazilian origin dances… The more you have enjoyed yourself during the day the less frustration you have, the less frustration you have the less you want to smoke.” Four out of five will maintain their smoking cessation.
