Is NICE going too far?

[Sal321]

This BBC news story is about a suggestion by NICE (national institute for clinical excellence) that all pregnant women should be breath tested for smoking at their first MW appointment. I know I don't smoke, why should I be tested? I appreciate that I could refuse, but isn't this a bit of a weird recommendation?

Well said, Coalition, my friend Weetabix was saying this earlier.

Because everyone is different and has different choices to make?
Are you seriously telling me that you cannot understand that someone might be for abortion for other people but not wish to have one themselves?

Is there anyone out there who smokes and doesn't know it's harmful? And it is really a good use of NHS money to tell people what they already know?

I can think of a million better uses for that money, like cancer drugs or hip replacements.

Being asked to blow into a tube then what...info??...

You could just give information scary i know
'If you do smoke or are having problems giving up..xyz...dont need a machine to tell someone imo..if you are good at your job and deliver the information effectively I dont get the purpose of test unless you are trying to catch someone out because they could just say NO thanks..I was asked about smoking by my midwife ...I had stopped and told her that...end of story

if you are going to try to make woman feel guilty over smoking lets ban cars as well, they will damage baby with their output of carbon monoxide. It isn't any different how you get the poison.

banning cars from towns and cities for 8 hours per day would greatly reduce the risks to unborn children, children and adults. it would save lives and promote health and reduce the burden on the NHS

and I don't smoke...

coalition

and what? they get a brochure.
Oh great, I'll stop now! gee thanks
or an invite to a stop smoking session, that they wont attend either

bullshit, nothing will change

Persnickety - because people lie to themselves

"I don't REALLY smoke, just one or two a day"
"Wine in the Garden doesn't count"
"The advice keeps changing so I'll just do waht I want"

etc.

The idea is to get people to own up to their behaviour in a non-confrontational way.

Why are cancer drugs or hip replacements inherently better? Are there some figures about the relative merits of each?

I have no wish to start a debate about abortion that is off-topic.

I guess what I'm just trying to say (badly) is that in what crazy world do we live that people think it is ok to harm an unborn person, just because the mother is too lazy to change her ways.

I dont smoke never have but I'd refuse to be tested if all they're gonna do is treat me like a naughty kid. Stupid waste of time. Those who smoke and want to give up will make the effort to do so anyway without this test. Those who dont/cant will not give up smoking.

porcamiseria - Maybe some of them will stop, or at least cut down when presented with evidenc in this way.

Here's an idea, lets try it and then measure what the effect is on low birth rate and pre-term births.

"Evidence statement ER1.1
There is good evidence from one recently updated systematic review (++) on the effectiveness of interventions for promoting smoking cessation in pregnancy.
The review included 72 trials. Pooled results show that cessation interventions reduce smoking in late pregnancy (risk ratio [RR] 0.94, 95% confidence interval [CI] 0.93 to 0.96) and reduce incidences of low birth weight (RR 0.83, 95% CI 0.73 to 0.95) and pre-term births (RR 0.86, 95% CI 0.74 to 0.98) while increasing birth weight by a mean of 53.91 g (95% CI 10.44 g to 95.38 g).
The overall finding of the updated review is that smoking cessation interventions used in early pregnancy can reduce smoking in later pregnancy by around 6% (or 3% using studies least prone to bias)."

Or we could just keep going on about what we all 'reckon'.

hmm... driving the women who need antenatal care the most away by humiliating them, this gets on your record i suppose,... what's the penalty, no scans for your baby?, what happens in case of a false positive? is that possible?
what about drinking? or drugs? will they test you every week?
your midwife is there to support you.... ha!, sorry to say some of them are witches of the east,...
in an ideal world you should stop smoking, drinking, eating inadequately and start exercizing when you decide to try to get pregnant (not such a thing as an unplanned pregnancy), could someone point in a map where this ideal world is?
and no, i did not smoke, drink, or eat inadequately since like a month before conception date, and i already exercised regurlarly, but that wasn't planned either...

oh, i forgot, this must be part of the cost cuts on the nhs, or is only nurses numbers they are going to reduce?

The NHS Stop Smoking Service interventions for pregnant women described in these articles consist of a combination of behavioural support (delivered in a range of settings and formats) and NRT (for most but not all women). They report varied outcomes but those that included 4-week post-quit date outcomes reported quit rates of between 32% and 48%. However, evidence from a national study of smoking cessation services for pregnant women in Scotland found that the reach and effectiveness of services varied significantly between health boards. Some areas offered no tailored (specialist) smoking cessation interventions for pregnant women.

Actually, no hang on, you're right, NICE just pulled the advice out of their arse based on what someone in the office heard their mate say.

This is NOT an enforced test.

NO test is enforced, pregnant or not, as long as ou have capacity. I wish more people realised this.

God willing, will have my booking appointment in the next month or so, and shall be telling them exactly where they can stick their test.

I understand your point, GetDown but can you see mine? I entirely agree that someone who would rather smoke than have a healthy baby has something wrong with them. I entirely agree that they really shouldn't do it. But, and its a very big but, once you start on the road on telling pregnant women, or any women, what they can and cannot do, its a slippery slope.
Our fundamental right is to determine our own bodies, even when they are hosting a foetus. This cannot be allowed to be eroded, even in the slightest.

i did not understand a word of that

also, I dont mean this aggresively, why do you care?

Completely pointless and waste of resource, driving away the people who need the most help. No mention of whether partners will be made to be breathalysed?

What's next, MW going to come round and breathalyse me for alcohol every night?

I've never smoked but I find this so patronising and ineffectual. People who do smoke will continue to smoke and midwives will get so much hassle of people who either feel it's intrusive or are just general gobshites.

Everyone knows about the harm smoking does, it's not a secret, if people still smoke they've reconciled themselves to it somehow and humiliation in the form of a breath test isn't going to stop them.

off

yes I do understand what you are saying runnybottom actually your argument has really made me think.

I guess you have to give people the personal liberty to make their own mistakes, even if the general principle of what they are doing is wrong.

TCNY...for all the stats you just put up..do you get better results after a test or just after the information was given?..

Thank god you turned up CoalitionNeedsYou.

for the rest of you absolute morons - NICE are recommending the test due to the current research available.

IT IS EASY TO STOP SMOKING stop believing the myth that its difficult to stop. The withdrawal is a little bit annoying a bit like not being able to eat your favourite chocolate bar when its sitting in front of you.

If there is any good time to stop smoking its when your pregnant, you have an added incentive.

If it helps mums stop smoking then good - carry on, if the only inconvenience is me having to blow into a tube at my booking in appointment then fair enough.

The MW is unlikely to be judgemental should you test positive, she'll simply open up a big wide door to support services should you wish to make use of them.

Porcamisera - the point is that it is not a waste of time. There is good evidence that interventions for promoting smoking cessation in pregnancy reduces the number of low birth weight and preamture babies.
There is evidence that NHS Stop Smoking Programmes work. There is a load more evidence in the documents on the NICE website.

I care because the NICE recomendations are the results of research and analysis. The onjections that people are comign up with are...not.

The best way to find out if it works is to try it. So lets do that and stop inventing spurious reasons to object to it.