Pregnant women should take 'smoking test': what do you think?

I had a quick look for some more information about this and found out it was really pretty old news since the original NICE recommendation was in 2010. There were mumsnet threads about it then as well.

Why has this come up again today?

I've no idea numptymum. It'd be interesting to read a report on the Glasgow programme - presumably there has been some success in terms of percentage of women enrolling in smoking cessation services/reducing the amount they smoke during pregnancy or they wouldn't do it.

I can't see the point of doing it if they're getting a significant number of false positives. Identifying women who smoke during pregnancy is presumably fairly useless. It's increasing uptake in enrollment in intervention services that has the public health benefit, and again this is useless if it doesn't result in harm reduction (stopping smoking/reducing smoking/reducing smoking by partners around the mother & baby for eg).

I guess NICE must have had access to some evidence to base this recommendation. It would be interesting to see it, or to know if there is no evidence of benefit and they have indeed pulled the whole thing out of their arses as so many posters seem to believe.

Seems like a waste of time and money. obviously people know if they smoke or not and they can't force people to take a test or to stop smoking. all they can do is give them advice and support to stop smoking if its needed.

Sleepyhead: 'People lie. All the time. The data from doing the test in Glasgow showed that pregnant women who smoked lied 25% of the time about smoking in pregnancy.'

Presumably as one of those who took the test in Glasgow, twice, who said I was not a smoker (am not, smoked a few when I was 18 but was pregnant aged 37 first time) and then got a positive result: am I one of those 'liars'? Has my data been translated in this way? Is this what is behind the push to have this test nationwide? This is what absolutely concerns me.

I don't know WHY I got a positive, the MW didn't know either. I do not like the fact that my data, the discrepancy between what I said and the result that showed, could be translated in this way without me knowing about it. I DO NOT SMOKE. DH DOES NOT SMOKE. I GOT A POSITIVE RESULT. It was NOT from a faulty boiler because we only got central heating installed after I had my first baby. I lived above a heavy smoker; I cycled to work (though mostly along the canal path, so hopefully got less traffic pollution) and I lived in the middle of the city. These were the only reasons I could think of for why I had a positive, and they were worrying enough (ie implications for the health of my children).

I was lucky - my MW was inclined to trust me; but would that be the case if I had been young? If there had been other reasons not to 'trust' me?

Jux it is like another world here - basically it is half and half I guess. The entire system is funded via insurance providers - which you pick which ever one you like the look of (they all are basically the same) - a % of your salary covers this up to a threshold, and then you can opt out of the % of salary and pay a fixed amount - but you just use the same companies- this is to not penalise people earning over a certain amount. If you are on benefits, the insurance is covered by the government in the same way (although the whole benefits system is different too). You see a Gyn. for these appointments, and a midwife later on the the pg. They are used here for after the birth mostly to help you out - the same as in the UK - they come to your home if you want, can help with whatever feeding you do (your choice) etc etc.

They do test more here - i.e. more scans, test for toxiplasmosis, everyone has the GD test (well you can refuse if you want but it is covered), etc. You just get treated like you are not a total moron, obv. they do check things like smoking and drinking - and they advise not to do either if you would say yes, there is a very anti drinking in pg stance in Germany. But the drinking habits are diff between countries - regardless if pg or not. They have stacks of alcohol free beers here, that you get everywhere, so pg women just drink those instead. Although they check your blood for stuff, and you see the gyn every 4 weeks, I don't feel 'interfered' with - if you see what I mean. I would loathe to have to sit there with someone going through a checklist and a bit like 'computer says no' if you have something not on the list. I do feel much safer with an experienced Gyn. - she is an expert and has trained as such. They make a firm line here between midwives and doctors etc - so you don't get any conflicting advise. Personally I used to find that maddening in the UK - you get shunted to see a nurse, and they tell you something diff to a doctor anyway, since obv. Then you wait another half an hour for a doctor to sign your prescription etc etc. Then doctors are effectively downgraded into a 'health professional' role and on it goes. And then the patient is frankly fed up with everyone they come across. And now all this nonsense from NICE.....

This just sounds like a very, very daft way to treat women - all I can think of is the Harry Enfield sketch of Mr C 'Women - know your place'! and my worry would be women then go 'honestly sod it' - and treat all advise given the same way - even though some of it could be very valid.

It took several minutes to do mine. She could not for the life of her get the card mouthpiece on the machine. After a while I offered to have a try, turned it round, and fitted it first time, pointing out that one end of the card tube was wider than the other.

She did this face and wondered aloud why none of her colleagues had ever pointed that out.

Don't forget as well, Chunderella, that the answers will have to be written to the patient's medical record, and probably coded. At least one but probably several data returns will need to be made by the collecting organisation to a funding body or two, and then the results will need to be collated and analysed at the other end. Each area probably has a manager with a target to improve the number of tests per head of population and will have to spend time and resources improving the ratio and reporting back on outcomes.

It very much concerns me that some women would also not attend any ante natal care to avoid judgement over their smoking.
Surely if a woman ids going to smoke during pregnancy the unborn baby is going to be safer with ante natal care rather than without.

I gave up smoking for both pregnancies.

I would refuse to take a smoking test,and taking one wouldn't be my reason for giving up.

I would,however,like to be able to request one to measure my progress and to use it as a tool to give me encouragement and to show me that I had made a difference.

I don't smoke but would refuse to take the test and as a taxpayer think it is a waste of resources. What are they going to do if the result is positive, arrest people?

Do they have any evidence this would even reduce smoking, as I don't see how?

Teaandflapjacks, forgive my ignorance, but what is the health service like in Germany? I mean, is it private health insurance based or more like the NHS here? I think that if you are paying directly then they are more likely to treat you like adults, whereas if the State is making massive subsidies, like here, then they feel more able to dictate. I don't agree with the way we are infantilised by the State, especially in pg where it is more noticeable, but I can see the difference direct payment would make.

I remember being told to 'pop' all the time by midwives, "pop yourself up here", "pop your clothes off". I have never popped so much in my life.

This test is rubbish, it totally ignores all the potentially pregnant women, what if a woman was to fall pregnant because she wasn't being responsible, and then was too selfish to moderate her drinking, lifestyle and language to allow for the fact that she's female?

I think it's best if these tests are mandatory for ALL women because all of them are potential mothers, and how can you catch them lying and trying to avoid punishment for their transgressions (like being caught in possession of a vagina without a mitigating penis) if you don't test all of them?

Isn't this like trying to crack a nut with a hammer? Teaandflapjacks.

^Exactly this.

This way our illustrious leaders will look as if they are 'doing something' to discourage smoking/for the benefit of the nations health (bleurgh) without actually affecting the tobacco revenue to the treasury one jot.

Jimmy-five-pints or whoever may still die a painful death of lung cancer or summat after his years of massive treasury donations but the gov. will say 'we tried to tell the people it wasn't good for them' without ever really addressing it at all.

It didn't bother me because I knew what it would say.

I also knew what my HIV etc blood results would be. But I consented to them too.

Perhaps there's a better way...

I'd be happy to choose to be tested for a range of pollutants I'm breathing in generally (not just if I smoke or not), such as vehicle pollutants, factory smoke, waste dump fumes etc etc to get the complete picture.

I don't believe it's just carbon monoxide that causes problems and that comes from many sources (eg: gas fires and boliers), not just smoking.

I would like to know what my kids are breathing in.

It's just a little gadget, disposable mouthpiece, a few moments at an appointment you already have.
All the talk about expense and time on NHS resources is neither here nor there - they must have decided that compared with the cost of complications because of smoking it's worth trying to help some mums to admit to needing support.
Knowing the risks re how well the placenta might function how long it could last, high blood pressure etc all might help the midwife have a clearer picture with regards to needing closer monitoring, advise re going overdue and all sorts of things.

Isn't this like trying to crack a nut with a hammer? Every pregnant woman knows it is bad for the baby to smoke in pregnancy, I can't honestly think anyone who is highly addicted sits there thinking 'oh stuff it' and enjoys chuffing away. People who are addicted in such away deserve kindness, support and help - not to be vilified and patronised. And how is giving nicotine substitutes a good thing? WTF?! And how unbelievably patronising. I am glad I live in Germany where such nonsense does not exist, and generally pg women here are treated like adults. I would also point blank refuse (I don't smoke) - since i have just said 'no' - so write that down! I think people get upset since it isn't something you need testing for without knowing the answer to yourself (i.e. like iron levels, or HIV etc - you may not know so a blood test is useful). This is a question you can perfectly well answer - and what if you live in a city centre and get a high reading - what can they do then - get you to move? I would worry about such info being on file, and eventually health insurance companies reading it later and fiddling about accordingly - if the NHS gets privatised. If you see what I mean.

iclaudis - of course 37 is not old, I was kidding!

Amazing mumof6 that is not old!

I don't get hassle re the testing but DO get asked about the 'same father'

This makes me irrationally angry. Bloody nanny state. Since I had DC, I cannot believe how I am treated by dentists, school etc. I am not a child FFS.

We have this test where I live in Scotland, honestly didn't bother me to do it. I don't smoke. My sister doesn't smoke either but her level came back high; turns out there is CM in the lab she works in. So was worth doing for her.

It didn't even cross my mind that they were testing me because they didn't believe me.

I'd miscarried a few months before & was so pleased to be pregnant that really puffing on a tube really wasn't high on my list of priorities.

I have to say I don't get why people are getting so upset about this.

awwwwmannnn - yes 37 is ancient and we must be the same age roughly - so let's get a purple rinse!
just wait until I'll get pg with number 7, I'll be 39+! I will refuse any invasive testing as have done so far and if I get asked one more time if the pg was planned I'll probably scream....

I'm glad you have a healthy child, congrats!