Globally, tobacco use is the leading cause of morbidity and mortality, causing an annual death rate of seven million people. In Australia, tobacco use is responsible for 9% of the total burden of disease. Smoking during pregnancy remains a significant public health problem for specific population groups, causing miscarriage, stillbirth, low birth weight and more. Psychosocial interventions such as behavioural counselling have been shown to be effective. Clinical guidelines in Australia recommend using the 5As approach: Ask about smoking status; Advise briefly to quit; Assess nicotine dependence and motivation to quit; Assist as needed (including behavioural counselling and nicotine replacement therapy [NRT] if required); and Arrange follow-up and referral to smoking cessation support services. NRT is recommended if the woman is unable to quit using only behavioural counselling, with oral NRT considered as first line.
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