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?

alle01 of course your carpet was not up to standard,you've been in hospital and dh was left in charge,what did she expect.

This is an outrageous proposal, may as well give women a lie detector. I would not want to live in a country that treats pregnant women in this way.

I don't smoke, never have done and can't understand why anyone would.
However testing women is SO patronising! A non smoking midwife would be able to tell if a woman smoked as soon as she walked in the room. If the woman denies she smokes she obviously sticking her head in the sand and will do whether tested or not.

Alot of the time pregnant woman are treated like dumb vessels. Why are they weighed? They could simply be asked for that infomation!

Im offended enough by the fact they feel it nessesary to ask at every midwife and health visitor appointment if you smoke or have a fire alarm. It makes me want to scream "I SAID NO THE FIRST TIME SO GUESS WHAT? ITS STILL NO!"

Its just so sad that they feel the need to nanny us so much, they forget that there are people out there who are educated and live healthy lives. They just dont seem to want to believe it.

The other day my health visitor asked me how i coped when my baby had screaming fits? and when i replied she never does she looked at me as though i was liying and continued to press me on the subject. Sorry for being such a boring case with a very good baby, but leave me alone. They need to look at better ways to educate people instead of trying to parent them and alienating them in the process.

lilyliz, i can tell you dh thinks he is very good at housekeeping, and you have to give to him that he is a lot better than my friends' dhs, and his friends, but obviously the carpet should have been a priority for him, not being with me at hospital all day and get things ready for baby at night, what was he thinking?

I have a chest infection at the moment at 21 weeks pregnant, so am wheezing like a fag ash lil! Does this mean they won't believe me when I say I don't smoke??!! (I don't by the way!)

If people want to smoke they will regardless, everyone has their vices its about time the powers that be just left people alone to make their own mistakes

I beg your pardon?

That will be news to the many scientific researchers who have been tirelessly looking for the cause of autism for years.

How ignorant are you?

I thought my midwife etc appoitments were a service for me and my babby. That in exchange for my taxes the NHS will look after us.
I didn't think i was attending in order to prove anything.

alle01 When I got discharged from hospital I asked dh to bring in clothes,should'nt have bothered.I left dressed in an orange and white cotton skirt,purple Fair Isle sweater,no tights and a pair of boots,this was in July.I can laugh now but it was e veryone else who was laughing at the time.

ProfLayton - The point of the test, from thew guidance "Some women find it difficult to say that they smoke because the pressure not to smoke during pregnancy is so intense. This, in turn, makes it difficult to ensure they are offered appropriate support. A carbon monoxide (CO) test is an immediate and non-invasive biochemical method for helping to assess whether or not someone smokes"

Mumcentreplus - "coercion is a bad thing if you have half a brain..I dont want to be forced,tricked or threatened thanks.." The NHS is not there just for you. It is there for everyone, and we all pay for it. So if coercion is the best way to ensure the best most cost effective outcomes, then I don't care if that offends you. It will help others.

I haven't been through the evidence review documents, but not sure whether they've got anything to support the "those who would otherwise have lied about smoking will take the test rather than refuse it" assumption. Although I suppose that's why it's being presented to women as if it's compulsory when of course it isn't.

I just don't want us to end up like swathes of America where a pregnant woman in her third trimester can't get anyone to serve her one small glass of white wine. And acceptance of this feels like the first step on an extremely slippery slope.

Given that this seems too stupid to be true, I've been thinking about what they should have done.

My DH had a carbon monoxide test when he went for a smoking cessation appt with the district nurse. He said that seeing the result really had an impact on how he thought about smoking, i.e. that it really is like they say it is and he didn't have magic lungs after all.

They've missed an opportunity here to say to those who admit to smoking "would you like a test to see how it's affecting your lungs, etc?" because the obvious implication is "to see how it's affecting your baby".

Women who smoke during pregnancy know about the risks, but "seeing" them might be more motivating. And if they don't admit to it in the first place then just leave it (either that or if midwife has suspicions say "well that's great - smoking does this and this and this, which I'd hate for you to worry about.. it's really just as well there are all these stopping smoking services to help women in that position etc etc")

I absolutely agree with you ProfLayton. It's a slippery slope we're getting onto here and one that I don't want to be on at all.

Very worrying. I do hope this idea gets chucked, and quickly. NHS midwives are already overworked and short on time and surely don't need to waste another five minutes per appointment with this pointless test. I'm glad to see the article states that midwives also seem to be against introducing this test.

Is there an iota, a scintilla, of evidence that providing midwives with smoke detectors (geddit) would prevent a miscarriage/prem birth/low birthweight baby? If there is, let's have a good old double blind controlled trial in one health area, and compare results. If it's cost effective ie the detectors result in money saved due to fewer low birthweight/miscarried/prem births then perhaps the idea is a good 'un. Until then, let's wait and see, and definitely not spend money on it.

'The NHS is not there just for you. It is there for everyone, and we all pay for it. So if coercion is the best way to ensure the best most cost effective outcomes, then I don't care if that offends you. It will help others'

You are mistaken TCNY, I never stated the NHS is there just for me or anyone else,a person with half a brain (or a whole one) including myself should not have to experience coercion in any form, its important to care if it offends people including me because it may not be effective at all..as i said if you want to help people educate them...no need for a breath-test like I was just caught drink driving..treat people with respect...coercion is not respect

MumCentrePlus - Obviously if it doesn't work stop doing it. But where coercion is effective it should be used. If this test embarrases some people into giving up smoking while pregnant, good. If the cost of that is some mild irritation to people who think that because they never lie to the doctor that the doctor should automatically know that - tough.

So you object to the routine HIV tests? What if you tell the doctor you and your partner have never slept with anyone else/used IV drugs etc. Should they just take your word for it?

The only issue we should be considering about the guidelines is "Do they work?".

And we won't know that until we try them.

Yes, but looknat the guidelines;
'find out if anyone in the house smokes. if not give positive feedback'.
that language sums it up surely. 'Pat pat. Patronise patronise. Infantalise'.

I'm not a smoker and neither is my dh, but I think it is utterly patronising to ask women to do a breatherliser for smoking. An utter waste of resources. Everyone knows smoking is bad for you and I guess most pregnant women smoking is extremely harmful to their babies. Enough said.

Oh God, the health fascists are back. The evidence of smoking whilst pregnant is just not there. The carbon monoxide just from cars is enought to give you a positive reading in these tests.

Time for nanny state to take a long, long nap.

"if coercion is the best way to ensure the best most cost effective outcomes then I don't care if that offends you. It will help others."

Heavens, there was I thinking I was a free person and the S in NHS stood for Service and not Schutzstaffel.

it seems a bit like saying "no alcohol", when actually there is very little evidence that small amounts are a problem.
Overall, fewer people drink excessively. But lots of people don't drink at all who could have had half a glass occassionally without being made to feel guilty.
Presumably it is way of demonising smoking, aiming at cutting the overall incidence.

First let me say I'm not only a non-smoker, I'm an anti-smoker, and the sooner they ban it the better (I remember being told at school 40 years ago how it had been proven to be harmful, and how angry we all got about the ongoing cruelty to beagles when the bad effects were already known). I'm appalled that so many apparently well-educated and intelligent people even start in this day and age.

BUT

At least two posters on this thread have stated "giving up smoking is easy"... How the feck do they know? It's just like not being able to help yourself to a biscuit that's within reach... er, no, it bloody well isn't for most people. Fortunately as I've never smoked I've never had to give it up, but I have a number of friends and family who appear to have as much self-control as the rest of us in most ways, but who find giving up smoking, at least in the long term, extremely hard. It's just wrong to make a sweeping statement like "it isn't hard". Maybe it wasn't hard for them when they gave up, doesn't mean it's easy for everyone. Reminds me of those infuriating women who have an easy birth and assume that everyone else could do it that way if only they relaxed more; or a hideously opinionated ex-colleague who assured us that there is no such thing as dental pain, we are only hurt at the dentist because we expect to feel pain. Was tempted to knock his teeth down his throat, except he wouldn't have felt it, of course.

And what a feckin' stupid idea to make a CO2 test compulsory. I'm pretty shocked to hear that although this report has only just come out today, women have been given this test for at least the last couple of years without being told they had the right to refuse it. Dreadful waste of scarce resources to have a machine in every clinic anyway. Just bloody ask the woman if she or anyone in her household smokes. The vast majority will tell the truth. For the rest, just hand out standard leaflets about various dangers including smoking as a matter of course. (Don't tell me they don't snow you under with little bits of paper these days? Though I guess a serious nicotine junkie would just make roll-ups with the leaflet...)

I feel sorry for the poor m/w's who are going to have to administer this! I can't believe that they're all going to be happy about it.