Introduction:
Smoking during pregnancy is a leading preventable cause of low birth weight and preterm delivery. Infants and children exposed to tobacco smoke in utero and post natally are at increased risk for otitis media, wheezing and asthma, and lower respiratory tract infections. In Turkey, little is known about smoking during pregnancy, although one study revealed that 28% of women smokers continued to do so throughout their pregnancy. This paper reports on formative research conducted with pregnant and postpartum women on smoking behavior and the training of pediatric nurses and midwives in cessation counseling in Turkey.

Material and Methods:
Fifteen interviews with women were conducted to explore smoking behaviors during pregnancy and postpartum, to assess understanding of the harms of smoking, and interest in quitting. Interviews with pediatric nurses and midwives were also conducted to explore their attitudes toward training in cessation counseling. Following data analysis, 18 nurses and midwives were trained on harms of tobacco use during pregnancy and postpartum, the harm of secondhand smoke exposure and cessation counselling skills. Following training, nurses and midwives were debriefed to explore patient’s responses to quit advice and challenges faced during cessation counseling.

Results:
Many women reduced their level of smoking during pregnancy and some were able to quit entirely. However, after delivery, many relapsed to smoking. Women’s understanding of the harm of smoking to their children was limited to respiratory illness. Nurses and midwives felt confident in delivering cessation messages and noted that women were receptive to the importance of quitting once they understood the harm of secondhand smoke to their children.

Conclusions:
Given the prevalence of smoking among women in Turkey, there is a clear need for nurses and midwives to ask and assess smoking status during pregnancy visits and to offer cessation advice to all those for smoke.

Funding:
Funding was provided by Global Bridges, Mayo Clinic, U.S.