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  • Sheila Ward CNM, MSN

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    • Sheila Ward is a 1981 graduate of the Frontier School of Midwifery and Family Nursing. She obtained a master's degree in nursing science at the University of Louisville in 1995. Her clinical experience includes full-scope midwifery practice in Mississippi and Kentucky. She is currently providing continuing education for the Kentucky Department for Public Health, and providing prenatal and family planning care in the North Central District Health Department. She is coordinating a prenatal smoking intervention study in two Eastern Kentucky counties.

Sheila Ward, CNM, MSN, Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Louisville, KY 40292.


Smoking is the leading preventable cause of cancer, cardiovascular disease, and other premature deaths among women in the United States. Tobacco use accounts for 10% of perinatal mortality and is 100% preventable. Smoking is now more common among adolescent girls than among boys. Women's health care providers are in an excellent position to intervene in this growing epidemic. This article addresses the health consequences of smoking as well as the social, economic, and emotional toll of cigarette smoking on the woman and her family. The reasons women begin and continue smoking in spite of known risks are examined. The role of the midwife in treating nicotine addiction in women throughout the life span is examined. A theoretical model based on the woman's stage of change is presented as a framework for intervention. Behavioral and pharmacologic treatment recommendations are included. Opportunities for professional activities for community education and advocacy for a tobacco-free society are presented.