{"id":1849,"date":"2020-12-15T09:43:46","date_gmt":"2020-12-15T09:43:46","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=1849"},"modified":"2025-11-04T14:13:40","modified_gmt":"2025-11-04T14:13:40","slug":"helping-pregnant-women-quit-smoking-sharing-best-practice-from-the-uk","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/cz\/2020\/12\/helping-pregnant-women-quit-smoking-sharing-best-practice-from-the-uk\/","title":{"rendered":"Pomoc pro t\u011bhotn\u00e9 \u017eeny, jak p\u0159estat kou\u0159it. Sd\u00edlen\u00ed osv\u011bd\u010den\u00fdch postup\u016f z Velk\u00e9 Brit\u00e1nie"},"content":{"rendered":"<p><strong>Autor: Felix Naughton, University of East Anglia, Velk\u00e1 Brit\u00e1nie<\/strong><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Asi 25%\u201350% ku\u0159a\u010dek p\u0159est\u00e1v\u00e1 kou\u0159it pot\u00e9, co zjist\u00ed, \u017ee jsou t\u011bhotn\u00e9. Pro\u010d ale ostatn\u00ed \u017eeny pokra\u010duj\u00ed v\u00a0kou\u0159en\u00ed po cel\u00e9 t\u011bhotenstv\u00ed? \u00a0 <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><i><span style=\"font-weight: 400;\">Nev\u011bd\u00ed snad, \u017ee kou\u0159en\u00ed b\u011bhem t\u011bhotenstv\u00ed je \u0161kodliv\u00e9?<\/span><\/i><span style=\"font-weight: 400;\"> V\u011bt\u0161inou ano. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22311960\/\"><span style=\"font-weight: 400;\">Jedna z na\u0161ich studi\u00ed ve Velk\u00e9 Brit\u00e1nii<\/span><\/a><span style=\"font-weight: 400;\">, kter\u00e1 zahrnovala t\u011bhotn\u00e9 \u017eeny motivovan\u00e9 i nemotivovan\u00e9 k\u00a0ukon\u010den\u00ed kou\u0159en\u00ed, zjistila, \u017ee a\u017e 99% z\u00a0nich do jist\u00e9 m\u00edry souhlasilo s prohl\u00e1\u0161en\u00edm \u201ekou\u0159en\u00ed b\u011bhem t\u011bhotenstv\u00ed m\u016f\u017ee m\u00e9mu d\u00edt\u011bti v\u00e1\u017en\u011b ubl\u00ed\u017eit\u201c a p\u0159ibli\u017en\u011b 75% z\u00a0nich s\u00a0v\u00fdrokem souhlasilo velmi nebo velmi siln\u011b. P\u0159esto o 12 t\u00fddn\u016f pozd\u011bji abstinovalo m\u00e9n\u011b ne\u017e 10% z nich. A\u010dkoli je <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5695489\/\"><span style=\"font-weight: 400;\">pokus o odvyk\u00e1n\u00ed pravd\u011bpodobn\u011bj\u0161\u00ed<\/span><\/a><span style=\"font-weight: 400;\"> u osob se silnou \u201ev\u00edrou o \u0161kodlivosti\u201c kou\u0159en\u00ed v t\u011bhotenstv\u00ed, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5896485\/\"><span style=\"font-weight: 400;\">nezd\u00e1 se, \u017ee by p\u0159\u00edli\u0161 zvy\u0161oval \u0161ance na \u00fasp\u011bch.\u00a0<\/span><\/a><\/p>\n<p><!--more--><span style=\"font-weight: 400;\">Shrnut\u00ed: V\u00edra o \u0161kodliv\u00fdch \u00fa\u010dinc\u00edch kou\u0159en\u00ed v t\u011bhotenstv\u00ed m\u00e1 jen malou roli.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Chyb\u00ed motivace<\/span><\/i> <i><span style=\"font-weight: 400;\">k\u00a0ukon\u010den\u00ed kou\u0159en\u00ed?<\/span><\/i><span style=\"font-weight: 400;\"> N\u011bkdy je to pravda. <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5695489\/\"><span style=\"font-weight: 400;\">Na\u0161e pr\u00e1ce<\/span><\/a><span style=\"font-weight: 400;\"> nazna\u010duje, \u017ee na za\u010d\u00e1tku t\u011bhotenstv\u00ed m\u00e1 \u00famysl p\u0159estat kou\u0159it v dal\u0161\u00edch 30 dnech necel\u00e1 polovina \u017een, a podobn\u00fd po\u010det \u017een se pokus\u00ed s\u00a0kou\u0159en\u00edm skon\u010dit. S\u00a0pokra\u010duj\u00edc\u00edm t\u011bhotenstv\u00edm se zd\u00e1, \u017ee motivace p\u0159estat kou\u0159it kles\u00e1. Je p\u0159ekvapiv\u00e9, \u017ee p\u0159\u00edtomnost motivace <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5896485\/\"><span style=\"font-weight: 400;\">nezvy\u0161uje \u0161ance<\/span><\/a><span style=\"font-weight: 400;\"> na \u00fasp\u011bch p\u0159i pokusu p\u0159estat kou\u0159it. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21752135\/\"><span style=\"font-weight: 400;\">Tot\u00e9\u017e se d\u011bje u ostatn\u00edch ku\u0159\u00e1k\u016f<\/span><\/a><span style=\"font-weight: 400;\"> a ku\u0159a\u010dek, kter\u00e9 nejsou t\u011bhotn\u00e9<\/span><span style=\"font-weight: 400;\">. Krom\u011b toho jsme podle \u00fadaj\u016f z <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2947553\/\"><span style=\"font-weight: 400;\">randomizovan\u00fdch a kontrolovan\u00fdch pokus\u016f<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">kter\u00e9 hodnotily \u00fa\u010dinnost intervence pomoc\u00ed motiva\u010dn\u00edch rozhovor\u016f a poradensk\u00fdch p\u0159\u00edstup\u016f zam\u011b\u0159en\u00fdch na zv\u00fd\u0161en\u00ed motivace ke zm\u011bn\u011b chov\u00e1n\u00ed zjistili, \u017ee tento p\u0159\u00edstup nen\u00ed pro ukon\u010den\u00ed kou\u0159en\u00ed v t\u011bhotenstv\u00ed \u00fa\u010dinn\u00fd.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Shrnut\u00ed: Motivace zvy\u0161uje \u0161anci, \u017ee \u017eena zkus\u00ed p\u0159estat kou\u0159it, ale motivace sama o sob\u011b nesta\u010d\u00ed k tomu, aby k\u00a0abstinenci do\u0161lo.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><i><span style=\"font-weight: 400;\">Chyb\u00ed z\u00e1jem o pomoc, kdy\u017e cht\u011bj\u00ed p\u0159estat kou\u0159it?<\/span><\/i><span style=\"font-weight: 400;\">\u00a0 To opakovan\u011b plat\u00ed v\u00a0n\u011bkter\u00fdch (ale ne ve v\u0161ech) p\u0159\u00edpadech. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31570944\/\"><span style=\"font-weight: 400;\">Zjistili jsme<\/span><\/a><span style=\"font-weight: 400;\">, \u017ee p\u0159ibli\u017en\u011b polovina t\u011bhotn\u00fdch cht\u011bla pomoci s ukon\u010den\u00edm kou\u0159en\u00ed na po\u010d\u00e1tku t\u011bhotenstv\u00ed. \u00darove\u0148 z\u00e1jmu o tuto podporu na rozd\u00edl od motivace z\u016fst\u00e1vala a\u017e do pozdn\u00edho t\u011bhotenstv\u00ed. Ale pouze p\u0159ibli\u017en\u011b jedna \u017eena z deseti uv\u00e1d\u011bla, \u017ee m\u00e1 b\u011bhem t\u011bhotenstv\u00ed kdykoliv p\u0159\u00edstup k podpo\u0159e p\u0159i odvyk\u00e1n\u00ed kou\u0159en\u00ed. Ty, kter\u00e9 jej m\u011bly uvedly, \u017ee m\u011bly v\u011bt\u0161\u00ed z\u00e1jem o podporu na za\u010d\u00e1tku t\u011bhotenstv\u00ed. Mo\u017enost promluvit si se zdravotn\u00edkem o ukon\u010den\u00ed kou\u0159en\u00ed bylo siln\u011b spojeno se z\u00e1jmem o poskytovanou oporu, tak\u017ee to m\u016f\u017ee b\u00fdt p\u0159\u00edm\u00fd zp\u016fsob, jak zlep\u0161it p\u0159\u00edstup \u017een k pomoci.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Shrnut\u00ed: Rozhovor s t\u011bhotnou \u017eenou o ukon\u010den\u00ed kou\u0159en\u00ed m\u016f\u017ee zv\u00fd\u0161it jej\u00ed z\u00e1jem o podporu, co\u017e by zase mohlo zv\u00fd\u0161it \u0161anci na jej\u00ed p\u0159ijet\u00ed. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><i><span style=\"font-weight: 400;\">Existuj\u00ed n\u011bjak\u00e9 \u00fa\u010dinn\u00e9 zp\u016fsoby, jak pomoci t\u011bhotn\u00fdm \u017een\u00e1m? <\/span><\/i><span style=\"font-weight: 400;\">Na\u0161t\u011bst\u00ed ano. Studie prok\u00e1zaly, \u017ee t\u011bhotn\u00fdm \u017een\u00e1m mohou p\u0159i ukon\u010dov\u00e1n\u00ed kou\u0159en\u00ed pomoci: behavior\u00e1ln\u00ed podpora a strukturovan\u00e9 poradenstv\u00ed a pomoc p\u0159i zvl\u00e1d\u00e1n\u00ed behavior\u00e1ln\u00edch aspekt\u016f kou\u0159en\u00ed a odvyk\u00e1n\u00ed (i kdy\u017e ne motiva\u010dn\u00edmi pohovory), a\u0165 u\u017e <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD001055.pub5\/full\"><span style=\"font-weight: 400;\">formou individu\u00e1ln\u00ed pomoci<\/span><\/a><span style=\"font-weight: 400;\">, nebo <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18339103\/\"><span style=\"font-weight: 400;\">formou sv\u00e9pomoci<\/span><\/a><span style=\"font-weight: 400;\">, v ti\u0161t\u011bn\u00e9 nebo <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29912621\/\"><span style=\"font-weight: 400;\">digit\u00e1ln\u00ed podob\u011b<\/span><\/a><span style=\"font-weight: 400;\">. P\u0159ipojen\u00ed substitu\u010dn\u00ed terapie nikotinem (Nicotine Replacement Therapy &#8211; NRT) k behavior\u00e1ln\u00ed podpo\u0159e u \u017een se st\u0159edn\u00ed nebo vysokou z\u00e1vislost\u00ed na nikotinu <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD010078.pub3\/full\"><span style=\"font-weight: 400;\">pravd\u011bpodobn\u011b zv\u00fd\u0161\u00ed \u00fa\u010dinnost podpory<\/span><\/a><span style=\"font-weight: 400;\">. D\u016fkazy jsou v\u0161ak relativn\u011b slab\u00e9, asi proto, \u017ee mnoho studi\u00ed uv\u00e1d\u00ed \u0161patn\u00e9 dodr\u017eov\u00e1n\u00ed pokyn\u016f u NRT. To je \u010d\u00e1ste\u010dn\u011b zp\u016fsobeno obavami, \u017ee nikotin je pro d\u00edt\u011b \u0161kodliv\u00fd. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32621526\/\"><span style=\"font-weight: 400;\">V\u00fdb\u011br studi\u00ed<\/span><\/a><span style=\"font-weight: 400;\"> nejvy\u0161\u0161\u00ed kvality, kter\u00fd zahrnuje des\u00edtky tis\u00edc \u017een a kojenc\u016f v\u0161ak uk\u00e1zal, \u017ee neexistuj\u00ed d\u016fkazy o \u0161kodlivosti pou\u017e\u00edv\u00e1n\u00ed NRT v t\u011bhotenstv\u00ed. Na z\u00e1klad\u011b t\u011bchto zji\u0161t\u011bn\u00ed mohou b\u00fdt \u017eeny uji\u0161t\u011bny, \u017ee jak\u00e1koli rizika u\u017e\u00edv\u00e1n\u00ed NRT jsou v porovn\u00e1n\u00ed s pokra\u010duj\u00edc\u00edm u\u017e\u00edv\u00e1n\u00edm tab\u00e1ku n\u00edzk\u00e1. M\u00e9n\u011b zn\u00e1m\u00fdm faktorem je, \u017ee t\u011bhotn\u00e9 \u017eeny v d\u016fsledku zv\u00fd\u0161en\u00e9ho metabolismu <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11961061\/\"><span style=\"font-weight: 400;\">\u0161t\u011bp\u00ed nikotin v t\u011ble dvakr\u00e1t rychleji<\/span><\/a><span style=\"font-weight: 400;\"> ne\u017e kdy\u017e t\u011bhotn\u00e9 nejsou. To znamen\u00e1, \u017ee t\u011bhotn\u00e9 \u017eeny budou pro sn\u00ed\u017een\u00ed ba\u017een\u00ed a abstinen\u010dn\u00edch p\u0159\u00edznak\u016f pot\u0159ebovat v\u00edce NRT ne\u017e je obvykl\u00e9. Typicky v\u0161ak \u017eeny a zdravotn\u00edci <\/span><a href=\"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/hta21360#\/abstract\"><span style=\"font-weight: 400;\">up\u0159ednost\u0148uj\u00ed m\u00e9n\u011b NRT<\/span><\/a><span style=\"font-weight: 400;\">, ne\u017e je obvykl\u00e1 d\u00e1vka.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Jin\u00e9 formy dod\u00e1v\u00e1n\u00ed nikotinu, nap\u0159\u00edklad elektronick\u00e9 cigarety, mohou b\u00fdt b\u011bhem t\u011bhotenstv\u00ed stejn\u011b \u00fa\u010dinn\u00e9 jako mimo t\u011bhotenstv\u00ed. V sou\u010dasn\u00e9 dob\u011b ale nem\u00e1me d\u016fkazy na podporu t\u011bchto doporu\u010den\u00ed. \u0160kody zp\u016fsoben\u00e9 elektronick\u00fdmi cigaretami budou pravd\u011bpodobn\u011b v\u00fdrazn\u011b ni\u017e\u0161\u00ed ne\u017e \u0161kody zp\u016fsoben\u00e9 tab\u00e1kem. Pokud t\u011bhotn\u00e9 \u017eeny cht\u011bj\u00ed pou\u017e\u00edvat elektronick\u00e9 cigarety kv\u016fli tomu, aby jim pomohly p\u0159estat kou\u0159it, pak se ve Velk\u00e9 Brit\u00e1nii doporu\u010duje je v\u00a0tom <\/span><a href=\"https:\/\/smokefreeaction.org.uk\/wp-content\/uploads\/2019\/08\/2019-Challenge-Group-ecigs-briefing-FINAL.pdf\"><span style=\"font-weight: 400;\">podporovat<\/span><\/a><span style=\"font-weight: 400;\">. Jin\u00fdm \u00fa\u010dinn\u00fdm postupem je poskytov\u00e1n\u00ed finan\u010dn\u00edch pob\u00eddek pro dosa\u017een\u00ed abstinence, pokud jsou poskytov\u00e1ny spole\u010dn\u011b s podporou zm\u011bn chov\u00e1n\u00ed. <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD004307.pub6\/full\"><span style=\"font-weight: 400;\">V\u00fdzkumy<\/span><\/a><span style=\"font-weight: 400;\"> nazna\u010duj\u00ed, \u017ee pob\u00eddky jsou nej\u00fa\u010dinn\u011bj\u0161\u00edm p\u0159\u00edstupem, jak\u00fd zn\u00e1me.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Shrnut\u00ed: Behavior\u00e1ln\u00ed podpora je \u00fa\u010dinn\u00e1, zejm\u00e9na v kombinaci s nikotinovou substitu\u010dn\u00ed terapi\u00ed (NRT) u t\u011bch, kte\u0159\u00ed vykazuj\u00ed z\u00e1vislost na nikotinu, anebo\u00a0<\/span><span style=\"font-weight: 400;\">i<\/span><span style=\"font-weight: 400;\"> v\u00a0kombinaci s finan\u010dn\u00edmi pob\u00eddkami.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><i><span style=\"font-weight: 400;\">Kdo nejv\u00edce pot\u0159ebuje podporu?<\/span><\/i><span style=\"font-weight: 400;\"> P\u0159i odvyk\u00e1n\u00ed kou\u0159en\u00ed v t\u011bhotenstv\u00ed hraje roli <\/span><a href=\"https:\/\/www.researchgate.net\/publication\/321779987_Predictors_of_smoking_cessation_during_pregnancy_a_systematic_review_and_meta-analysis_Predictors_of_smoking-cessation\"><span style=\"font-weight: 400;\">mnoho faktor\u016f<\/span><\/a><span style=\"font-weight: 400;\">, nap\u0159\u00edklad ni\u017e\u0161\u00ed vzd\u011bl\u00e1n\u00ed nebo finan\u010dn\u00ed p\u0159\u00edjem. Faktory s\u00a0praktick\u00fdm dopadem jsou v\u0161ak tyto:\u00a0 kou\u0159en\u00ed partnera a m\u00edrn\u00e1 nebo vysok\u00e1 z\u00e1vislost na nikotinu \u2013 to jsou pro mnoho \u017een v\u00fdznamn\u00e9 p\u0159ek\u00e1\u017eky p\u0159i odvyk\u00e1n\u00ed. Dal\u0161\u00edmi faktory jsou p\u0159\u00edtomnost deprese a za\u017e\u00edv\u00e1n\u00ed vy\u0161\u0161\u00edho stresu b\u011bhem t\u011bhotenstv\u00ed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Shrnut\u00ed: \u017deny s n\u011bkter\u00fdmi nebo v\u0161emi t\u011bmito charakteristikami pravd\u011bpodobn\u011b budou pot\u0159ebovat intenzivn\u00ed a v\u00edceslo\u017ekovou podporu.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><b><br \/>\n<\/b><\/p>\n<p><b>Praktick\u00e1 doporu\u010den\u00ed<\/b><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> Poskytujte kou\u0159\u00edc\u00edm t\u011bhotn\u00fdm \u017een\u00e1m informace o rizic\u00edch kou\u0159en\u00ed pro n\u011b a jejich d\u00edt\u011b. Nab\u00eddn\u011bte tyto informace v\u0161em \u017een\u00e1m bez ohledu na jejich motivaci p\u0159estat kou\u0159it. Pro ty, kter\u00e9 odm\u00edtnou, pokra\u010dujte v podpo\u0159e po celou dobu t\u011bhotenstv\u00ed.\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Poskytujte strukturovanou behavior\u00e1ln\u00ed podporu, a\u0165 u\u017e osobn\u00ed, nebo sv\u00e9pomocnou, poskytovanou v ti\u0161t\u011bn\u00e9 podob\u011b nebo digit\u00e1ln\u011b, t\u011bm, kter\u00e9 jsou ochotny podporu p\u0159ijmout. Nevyu\u017e\u00edvejte motiva\u010dn\u00ed rozhovory.\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00da\u010dinnost podpory se pravd\u011bpodobn\u011b zv\u00fd\u0161\u00ed, pokud nab\u00eddnete n\u00e1hradn\u00ed l\u00e9\u010dbu nikotinem (NRT) t\u011bm \u017een\u00e1m, kter\u00e9 vykazuj\u00ed st\u0159edn\u00ed a\u017e vysokou z\u00e1vislost na nikotinu. \u017deny by v\u0161ak m\u011bly b\u00fdt podporov\u00e1ny v tom, aby l\u00e9\u010dbu vyu\u017e\u00edvaly \u00fa\u010dinn\u011b, dodr\u017eovaly rady zdravotn\u00edk\u016f a aby s\u00a0nimi komunikovaly o ve\u0161ker\u00fdch neopodstatn\u011bn\u00fdch obav\u00e1ch z u\u017e\u00edv\u00e1n\u00ed NRT b\u011bhem t\u011bhotenstv\u00ed. Pokud \u017eeny cht\u011bj\u00ed pou\u017e\u00edvat elektronick\u00e9 cigarety k tomu, aby p\u0159estaly kou\u0159it, mohlo by jim to pomoci, a m\u011blo by to b\u00fdt pova\u017eov\u00e1no jako p\u0159\u00edstup, kter\u00fd vede k minimalizaci \u0161kod.\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Pokud je nab\u00edzena NRT, povzbuzujte \u017eeny, aby ke sn\u00ed\u017een\u00ed ba\u017een\u00ed a abstinen\u010dn\u00edch p\u0159\u00edznak\u016f pou\u017e\u00edvaly dv\u011b formy (\u201ekombinovanou terapii\u201c, nap\u0159. n\u00e1plasti a \u017ev\u00fdka\u010dky), a aby maximalizovaly substituci nikotinu a sn\u00ed\u017eily tak ba\u017een\u00ed a abstinen\u010dn\u00ed p\u0159\u00edznaky.\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Pokud to zdroje dovol\u00ed, nab\u00eddn\u011bte jim finan\u010dn\u00ed pob\u00eddky pro abstinenci, v z\u00e1vislosti na proveden\u00e9m ov\u011b\u0159en\u00ed, nap\u0159. dechovou zkou\u0161kou pomoc\u00ed monitoru oxidu uhelnat\u00e9ho (CO).<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Prohl\u00e1\u0161en\u00ed o st\u0159etu z\u00e1jm\u016f: Dr. Felix Naughton nem\u00e1 \u017e\u00e1dn\u00e9 vazby ani finan\u010dn\u00ed spolu\u00fa\u010dast s v\u00fdrobci nikotinov\u00e9 substitu\u010dn\u00ed terapie nebo elektronick\u00fdch cigaret.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">P\u0159elo\u017eili: Radim Bado\u0161ek a Renata Hacklov\u00e1<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>By Felix Naughton, University of East Anglia, UK \u00a0Between 25-50% of female smokers quit smoking after they discover they are pregnant. But why do the remainder continue to smoke throughout their pregnancy? \u00a0Do they not know that smoking during pregnancy [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1879,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[8,41],"tags":[],"class_list":["post-1849","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-financial-incentives","category-smoking-cessation"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"cz","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","sr","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":true,"content":true,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":true,"content":true,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":true,"content":true,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":true,"content":true,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":true,"content":true,"excerpt":false},"ro":{"title":true,"content":true,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"sr":{"title":false,"content":false,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.9 - aioseo.com -->\n\t<meta name=\"description\" content=\"{:en}By Felix Naughton, University of East Anglia, UK Between 25-50% of female smokers quit smoking after they discover they are pregnant. 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