Australian doctors frequently ask pregnant women about cigarettes but rarely about cannabis, e-cigarettes, or secondhand smoke
While 95% of surveyed Australian GPs and obstetricians asked pregnant women about cigarette smoking, only 58% asked about cannabis and just 13-14% asked about e-cigarettes, potentially missing important exposures.
Quick Facts
What This Study Found
Among 378 Australian GPs and obstetricians, 95% asked pregnant patients about cigarette smoking at most visits. However, other exposures were assessed far less frequently: cannabis (58%), cannabis mixed with tobacco (38%), secondhand smoke (27%), e-cigarettes (13-14%), and chewing tobacco (10%).
Aboriginal health GPs were more likely to ask about cannabis compared to general obstetricians and GPs. The disparity suggests that healthcare providers focus heavily on cigarettes while underassessing other smoke and nicotine exposures that may also affect maternal and fetal health.
Key Numbers
378 GPs and OBS surveyed. Asking rates: cigarettes 95%, cannabis 58%, cannabis+tobacco 38%, secondhand smoke 27%, e-cigarettes 13-14%, chewing tobacco 10%. Aboriginal health GPs asked about cannabis more often.
How They Did This
Two cross-sectional surveys: one targeting GPs in Aboriginal and Torres Strait Islander health (NFATSIH) and another targeting GPs and obstetricians through RANZCOG. Surveys assessed frequency of asking about various smoke and nicotine exposures using Likert scales.
Why This Research Matters
If clinicians rarely ask about cannabis, e-cigarettes, and secondhand smoke during pregnancy, they cannot counsel patients about these exposures or track their prevalence. This assessment gap represents a missed opportunity for preventive health, particularly as cannabis and e-cigarette use are increasing.
The Bigger Picture
The dramatic difference between cigarette screening (95%) and cannabis screening (58%) likely reflects clinical training that has historically focused on tobacco. As cannabis becomes more normalized and e-cigarettes more prevalent, prenatal screening needs to expand to capture the full spectrum of exposures that could affect the developing fetus.
What This Study Doesn't Tell Us
Low response rate (6.2%). Australian healthcare context may not generalize to other countries. Self-reported screening practices may overestimate actual asking rates. The survey did not assess whether asking about cannabis changed clinical management.
Questions This Raises
- ?Would systematic screening for cannabis during pregnancy improve outcomes?
- ?Are there validated prenatal cannabis screening tools?
- ?How should clinicians counsel pregnant patients who disclose cannabis use?
Trust & Context
- Key Stat:
- 95% asked about cigarettes vs 58% about cannabis during prenatal visits
- Evidence Grade:
- Cross-sectional survey with low response rate. Identifies important practice gaps but may not represent all Australian clinicians.
- Study Age:
- Published in 2017. Prenatal screening for cannabis and e-cigarettes has received increasing attention since.
- Original Title:
- Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey.
- Published In:
- International journal of environmental research and public health, 14(12) (2017)
- Authors:
- Gould, Gillian S, Zeev, Yael Bar, Tywman, Laura, Oldmeadow, Christopher, Chiu, Simon, Clarke, Marilyn, Bonevski, Billie
- Database ID:
- RTHC-01386
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Should doctors ask pregnant women about cannabis?
Yes. Cannabis is the most commonly used illicit drug during pregnancy, and evidence links prenatal exposure to adverse outcomes. Only 58% of Australian clinicians in this survey routinely asked about it, meaning many opportunities for counseling are being missed.
Why do doctors ask about cigarettes but not cannabis?
Clinical training has historically focused on tobacco screening during pregnancy. Cannabis screening may be less routine due to its stigma, legal status, lack of standardized screening tools, and clinician uncertainty about how to respond to a positive disclosure.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-01386APA
Gould, Gillian S; Zeev, Yael Bar; Tywman, Laura; Oldmeadow, Christopher; Chiu, Simon; Clarke, Marilyn; Bonevski, Billie. (2017). Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey.. International journal of environmental research and public health, 14(12). https://doi.org/10.3390/ijerph14121585
MLA
Gould, Gillian S, et al. "Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey.." International journal of environmental research and public health, 2017. https://doi.org/10.3390/ijerph14121585
RethinkTHC
RethinkTHC Research Database. "Do Clinicians Ask Pregnant Women about Exposures to Tobacco ..." RTHC-01386. Retrieved from https://rethinkthc.com/research/gould-2017-do-clinicians-ask-pregnant
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.