Eighty per cent of pregnant women in Nunavut smoke

Ottawa’s Bob Reid is trying to understand what’s at the root of the health crisis

OTTAWA-When Ottawa’s Bob Reid convened a meeting several years ago to discuss Nunavut’s smoking epidemic, the territory’s health officials, Inuit elders and leaders all shared an overriding concern.

Nunavut’s expectant mothers smoked too much, they told him, and required urgent help.

“One of the things that was appalling to community members was the degree to which women continued to smoke throughout pregnancy,” says Reid, associate director of the rehabilitation centre at the University of Ottawa Heart Institute.

Reid, an expert in smoking cessation and behaviour modification, works with heart patients trying to break their addiction to tobacco.

About one-quarter of the 7,000 patients who visit the institute every year are smokers. (Smoking is a leading risk factor for heart disease.)

But the scale of the epidemic among Nunavut’s expectant mothers is of a different magnitude: studies show that up to 80 per cent of pregnant women in the territory smoke.

That level of tobacco use has profound effects on the health of Nunavut’s infants, who suffer the world’s highest rates of hospitalization for pneumonia, bronchiolitis and other respiratory infections.

After his meeting with Nunavut leaders, Reid searched for studies that explained the smoking behaviour of Nunavut’s expectant mothers, and finding none, he began to design his own.

He now leads a team of researchers trying to understand what’s at the root of the North’s most confounding health crisis.

Pregnancy is normally a galvanizing event for women who smoke.

“It is actually the single one event in a woman’s life that will more likely lead to quitting than anything else, even more so than a health problem,” says Reid, who holds a doctorate in health studies.

In Nunavut, however, pregnancy does not often compel expectant mothers to quit.

Reid’s team wants to know why — and what can be done to help more pregnant women overcome their addiction.

As part of the study, researchers are conducting interviews at an Iqaluit guest house where expectant mothers from outlying communities stay in the last month of their pregnancies. The women are flown to Iqaluit so they can deliver their babies at the territory’s only hospital, Qikiqtani General. They are exploring expectant mothers’ attitudes about smoking and pregnancy. Do they believe smoking will not affect their baby? Do they intend to offer their baby for adoption? Does that decision affect their attitude about smoking? Are they worried about weight gain? Does everyone around them smoke at home?

“We just don’t have any preconceived ideas,” Reid says. “If we’re going to design an intervention, we need to have someplace to start.”

Right now, he says, his research team does not have answers. “I think we need to develop a culturally sensitive intervention that combines the best of what we know about how to treat this from clinical experience with something that is sensitive to where women are coming from on this whole thing.”

Nunavut remains in the early days of its campaign against smoking, he says, with attitudes not unlike those found in Ontario in the 1960s.

It wasn’t that long ago, the 52-year-old Reid notes, that the Ottawa Heart Institute maintained smoking rooms for its medical staff. “I think we have to recognize that even in the south, the culture did not change overnight.”

source: www.ottawacitizen.com

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