The Guide for Counseling Women Who Smoke was developed by the Women and Tobacco Coalition for Health and published by the NC DHHS Div. of Public Health Women’s and Children’s Health Section. You can download the entire guide or explore key information in this section of the website.

Counseling Women who Use Tobacco: Common Concerns

Can I really make a difference?

  • YES. Seventy-five percent of women smokers report wanting to quit.
  • Quit rates increase by 30 – 70 percent when pregnant smokers are counseled by health care providers and provided with self-help materials.
  • Pharmacotherapy has been shown to increase cessation rates and should be considered as part of tobacco cessation treatment for non-pregnant tobacco users.
  • You have a special opportunity and the privilege to make a difference. Research shows that women expect and want their providers to address tobacco use and to support them while quitting.

It’s hard to find time to counsel tobacco users.

  • Counseling sessions as brief as 3 minutes or less can increase cessation rates for non-pregnant smokers.
  • Counseling sessions as brief as 5 to 15 minutes can be effective with pregnant women.
  • This guide will suggest specific opportunities and ways to counsel women, including pregnant women, who use tobacco in the time you currently spend with them.
  • At every visit, ask about her tobacco use status and provide clear and direct advice to quit; each interaction has an impact on those who use tobacco.

I don’t have time to learn.

  • The methods and instructional materials in this guide and the accompanying video will give you enough information so you will feel knowledgeable and comfortable counseling women who use tobacco.
  • This guide provides information on how to counsel women who use tobacco in a clear, concise, and easy-to-follow format.

Who should do this counseling?

  • Counseling delivered by a variety of clinician types, including physicians and non-physicians increases quit rates. All clinicians should provide tobacco cessation counseling interventions.
  • Counseling provided by more than one type of clinician is more effective.
  • For non-pregnant women, the most effective approach is using a combination of tobacco cessation counseling and pharmacotherapy.
  • For pregnant women, the most effective approach is using a combination of tobacco cessation counseling and self-help materials.
  • Smokers cite a physician’s advice to quit as an important motivator for attempting to stop smoking.

Can providers who currently use or have used tobacco counsel effectively?

  • If you’ve never used tobacco, be ready to answer the challenge that you do not know how hard it is to quit. Be prepared to share other ex-tobacco users’ experiences. It can also be helpful for providers to share their own experiences with addictive behaviors (e.g., eating).
  • If you are an ex-tobacco user, you may be able to help by sharing your experiences.
  • If you are a tobacco user, you may be less effective. Tobacco users may not see providers who use tobacco as credible sources of information on this issue. By continuing to use tobacco you send an inconsistent message to the patients whom you counsel to quit. (CDC MMWR, 2005)

What if the tobacco user has other unhealthy behaviors?

  • Give her all of the appropriate health information and help her set her own priorities.
  • If needed, refer her to alcohol or drug treatment. Call the Perinatal Substance Use Project – Alcohol /Drug Council of North Carolina at 1-800-688-4232 for assistance making an appropriate referral in North Carolina.

Where do I begin?

  • Right here and right now. Read this counseling guide. It provides you with the information you need to counsel women who use tobacco.
  • Create a tobacco-free workplace for both staff and visitors to reinforce that smoking and exposure to secondhand smoke is harmful.
  • Assess who among your staff should provide counseling or be trained to provide counseling.
  • Include as many staff as possible in your tobacco cessation program. Staff can help assess tobacco use status, provide advice to quit, provide support, make follow-up calls, counsel women, etc.
  • Obtain tobacco cessation educational materials to give to your patients, their partners, and family members. Refer to Resources section for more information on patient educational materials.