Many parents who use nicotine products recognize that there are risks to their health and the wellbeing of their baby. However, efforts to quit are complicated by a myriad of factors, especially for those who Black, Indigenous and People of Color. For instance, in addition to having higher rates of tobacco-related morbidity and mortality, research suggests that smokers who identify as African American also experience disparities in tobacco cessation counseling despite best practices for universal screening and counseling.1,2,4 As providers, we can positively impact the experiences of parents trying to quit using nicotine, especially those for whom health inequities exist. Below are some suggestions for becoming better partners with parents in tobacco treatment settings:

  • Listen to parents. We all know that quitting can be difficult. As providers, it is essential for us to understand the unique challenges of each parent, as well as their available resources if we are going to develop a quit plan that is realistic and attainable for them. If we are not collaborating with clients on strategies that meet their unique needs, quit attempts may not be as successful.
  • Practice cultural humility. A lack of awareness of cultural practices and rituals that are important to parents of diverse backgrounds may give the perception that these things are not valued or relevant to their quit attempts. It is important for us to recognize that culture matters in health care decision-making and behavior change. As such, it is imperative that we are intentional about understanding the lived experiences of those we serve and not imposing our values upon them.
  • Explore implicit biases. Implicit bias occurs when attitudes and perceptions unconsciously affect our behaviors. For providers offering nicotine cessation treatment, it is essential that we explore our implicit biases in working with specific populations and individuals and make appropriate corrections to behaviors that negatively impact care (e.g., decisions about who we offer services and what those services entail, confronting assumptions about treatment adherence). This may be difficult to discern without direct feedback from our clients. However, regular consultation and collaboration with colleagues from diverse backgrounds can support our efforts to be more aware of and reduce bias.
  • Address structural racism within our organizations. If we are to address the impact of structural racism in our organizational policies and practices, we must first acknowledge the systems of racism that exist. Prioritizing continuing education that focuses on anti-racism and cultural humility is an important first step. Ensuring that stakeholders are part of the process in creating nicotine cessation programs and services is also paramount. We should be developing programs with those who are seeking our services, not for

By becoming better partners to parents, especially those for whom health inequities exist, we can positively impact their well-being and the health of their babies. What commitment will you make to become a better partner?

References:

  1. https://www.sciencedirect.com/science/article/pii/S2211335518300421
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434788/
  3. https://www.cdc.gov/tobacco/health-equity/index.htm
  4. https://www.heart.org/-/media/Files/About-Us/Policy-Research/Fact-Sheets/Tobacco-and-Clean-Air/Structural-Racism-and-Tobacco-Fact-Sheet.pdf