April 22, 2019

While OB/GYN physicians are expected to provide smoking cessation counseling to their patients, the majority of OB/GYN residency programs provide only minimal education and training in this area, says a new report from Ball State University.

Smoking cessation education and training in obstetrics and gynecology residency programs in the United States” found that 60% of such programs did not have a formal, structured curriculum in tobacco topics and/or smoking cessation.

Sixty-five percent of programs did not formally evaluate residents’ competence in providing smoking cessation counseling to patients, the study also found. According to various estimates, 15 to 20% of American women of reproductive age are current smokers, and nearly 10% smoke during pregnancy.

“Smoking during pregnancy is a significant health risk for the mother, the developing child, and for family members who live with the smoker,” said Jagdish Khubchandani, a health science professor at Ball State who coordinated the study with faculty at the University of Toledo and Lourdes University in Sylvania, Ohio.

“Women who have never smoked are healthier and have better birth outcomes than women who do. The American College of Obstetricians and Gynecologists has stated that smoking cessation and preventing smoking relapse are important goals for OB/GYN physicians and their patients.”

The study found a lack of time was identified by 51% of the residency directors as a barrier to teaching smoking cessation. Another reason for the lack of tobacco-related education was that 27% of residency directors in the study believed that teaching residents about smoking cessation was not important for their future clinical practice.

“Considering the copious amount of evidence that strongly links tobacco use during pregnancy with deleterious health and birth outcomes and considering ACOG's clearly stated position on the importance of OB/GYN physicians providing smoking cessation counseling, it was surprising that more than one in four residency directors would hold such a belief,” Khubchandani said.

The study also found:

  • About half of residency programs reported spending less than one hour per year on teaching various basic science and clinical science topics related to tobacco use.
  • The majority of residency programs spent no time teaching residents about the socio-political aspects of tobacco use cessation.

Participants in the study, published in a recent issue of the Journal of Family Medicine and Family Care, included 158 of the 250 OB/GYN residency directors in the nation.

Khubchandani believes that residency is the best time to shape the future practices of physicians.

“Physicians who report using best practices in smoking cessation during residency are much more likely to do so in their future clinical practices,” Khubchandani said. “However, if residents’ knowledge and competence in smoking cessation are not evaluated during residency training, it is likely that residents will not view smoking cessation as a priority.”