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Introduction: Despite the magnitude of the risks associated with tobacco use during pregnancy, an estimated 6-19% of woman in Europe will continue to smoke during pregnancy and a large portion of woman who quit will return to smoking following pregnancy. The purpose of the pilot study was toexamine the effectiveness of the Tobacco Cessation Guidelines for High-risk Groups (TOB-G) for Pregnant and Post-Partum women on aiding cessation during pregnancy Methods: The intervention was based on the TOB-G project guidelines d in a sample of 67 pregnant women recruited from obstetrics outpatient visitsand was delivered based on an adaptation of the 5As models for smoking cessation. A research assistant contacted participants by phone at 1 and 6-months to document smoking status. Participants received three behavioural counselling sessions through a combination of face-to-face and telephone consultation. Results: A significant increase in self-reported smoking abstinence was documented following the intervention with 43.9% and 45.6% of participants abstinent at the 1 and 6-month follow-up respectively. In a conservative analysis if we assume missing data for participants we were unable to reach for follow-up as active smokers the quit rates are 26.9% and 38.8% at the 1 and 6-month follow-up respectively. Conclusion: The counselling intervention based on the TOB-G guidelines was associated with significant increase in smoking abstinence among pregnant women. Further research with larger sample sizes is needed.

Active and passive smoking during the perinatal period is one of the most important preventable causes of a variety of unfavorable pregnancy outcomes. Despite being informed about the risks at least one third of women still smoke during pregnancy. Greece has a smoking prevalence of 38%. It is essential for midwives to be trained in smoking cessation in order to help pregnant effectively to quit. Most women who quit smoking during pregnancy without following a smoking cessation program usually resume smoking within 6 months after delivery. We surveyed 294 midwives in Athens (professionals & students) in 2015 using a questionnaire to ascertain their perception and knowledge on: · the risks of active and passive smoking in pregnancy · smoking cessation in general · smoking cessation as part of their duty · the kind of information and help they should provide to pregnant smokers. Results: 1. Almost all participants reported that they routinely inform pregnant smokers about the risks of active and passive smoking. 2. The vast majority (97%) believe that smoking cessation is an important part of their role. 3. Only 51.7% reported feeling comfortable in offering quitting support. 4. 87.4% reported that pregnant women were not well informed about the risks of active and passive smoking. 5. Both professional and student midwives have insufficient knowledge on the effects of smoking during pregnancy and lactation (only 1% answered correctly all relevant questions). We conclude that midwives want to efficiently advise pregnant and breastfeeding smokers to quit. In order to be effective in this role they should be adequately educated on the effects of smoking during pregnancy and lactation and trained in smoking cessation strategies.

Active and passive smoking during pregnancy is the most important preventable cause of unfavorable pregnancy outcomes. We evaluated exposure to tobacco smoke (active/passive) and quitting methods using a questionnaire and depression using EPDS (Greek validated version of Edinburgh Postnatal Depression Scale questionnaire) of pregnant. 300 women were recruited from the perinatal care registers of 2 Public Maternity Departments in Athens during 2014. The questionnaires were administered on the 3rd postnatal day. 48% of mothers were smokers beginning their pregnancy.Among them 83,3% tried to quit but less than half (21,7%) managed to. Thus, finally 73.7% reported being non-smokers during pregnancy, but none in a smoke-free environment. The ones that failed to quit (26.3%) mostly (55.8%) felt unable. There were statistically significant differences between smokers and non smokers in pregnancy and fetal problems (χ2=11.41; df=5; p The mean EPDS score for smokers was 9.72 (SD=6.28;Std Error Mean 0.52) and for quitters 8.04 (SD=5.17;Std Error Mean:0.41). Smokers had significantly more depressive symptoms than quitters [Levene9s Test for equality of variances and homogeneity (F=43.059, P=0.0005) (t=2.403 df=298 Sig.(2-tailed)=0.0005]. Information about risks of active/passive smoking were given from internet/books (37.1%), midwives/doctors (32,1%) and family/friends (30,7%). We conclude that it is essential both pregnant and their partners/families are informed on the health risks of active and passive smoking. Only smoke-free environments will sufficiently promote optimal perinatal health for the woman and her fetus/newborn.