"My partner used to tell me: you'll never be able to stop smoking! My reward was to taunt him...", laughs Fanny, mother of a newborn, Telio, who like many pregnant women, has tried to drastically reduce her tobacco consumption.
"I had already tried before, but it was not conclusive. I did not want to poison this child that I had been waiting for 11 years," said this 42-year-old woman from Lyon, five days after giving birth, followed at the Femme Mere Enfant hospital.
With the help of a tobacco specialist midwife, she "went down to 15 cigarettes, then six, five, four, three..." "I was proud. The last two, early in the afternoon and before bed, are sticking," she explained to AFP ahead of the No Tobacco Month campaign in November.
If pregnancy is a crucial time to quit smoking, for the health of the future mother and that of her child, one in two smokers in France fails to quit, sometimes complicated by social difficulties, unequal access to support and a lack of information.
"Pregnancy is a very interesting lever, but the most dependent women cannot stop. The challenge is not to make them feel guilty but to support them," says David Saint-Vincent, psychologist at the Rouen University Hospital.
– “Fear of being lacking” –
The consequences can be serious for the 85,000 children born each year to mothers who smoke up until the third trimester (121% of women): "Prematurity, reduced birth weight, increased risks of addiction and smoking, psychiatric disorders, obesity and asthma...", recalls the Ministry of Health.
But quitting, even at the end of pregnancy, will have "a benefit," explains Marie Van der Schueren, a tobacco specialist at the Caen University Hospital. "The means to quit exist, but you just need to know how to prescribe them and use them."
Those who fail to do so at the beginning of pregnancy "have a physical dependence on nicotine," says Maud Catherine Barral, the midwife who followed Fanny. "We give them nicotine substitutes: a patch combined with gum, lozenges, an inhaler, a spray."
Reimbursed on prescription and without ceiling by Health Insurance, these substitutes can be prescribed by doctors, nurses, midwives or physiotherapists.
Smokers are "afraid of going through withdrawal" but "when we find the right dose, they are very surprised to feel so good without smoking" reports Corinne Adler, a midwife and tobacco specialist at the Parisian maternity hospital Les Bluets.
"Nicotine does not cause illness, unlike the combustion of a cigarette which releases 4,000 toxic compounds. But it causes dependency: to wean the woman gently, we must not hesitate to give her enough nicotine. Then we will have to help her wean herself off the substitutes," she says.
– “Young, precarious mothers” –
"According to scientific data obtained in a French study, managing to make at least three repeated one-week stops, thanks to tobacco monitoring, rather than continuing to smoke a few cigarettes a day, allows for a significant increase in the baby's birth weight," reports Dr. Anne-Laurence Le Faou, an addiction specialist at the Pompidou hospital in Paris.
But support is not always accessible to "young, precarious mothers in socio-economic difficulty", underlines Dr Van der Schueren.
"For some, it's already difficult to stop drinking alcohol... stopping smoking is experienced as a double punishment. Whereas to optimize things, you should stop both," she continues.
"Financial rewards in the form of vouchers could work to help pregnant women with social difficulties to wean themselves off alcohol," argues Dr Le Faou.
Each woman confronted with this addiction celebrates her victories in her own way, according to Mrs. Barral: "They will draw, paint, knit, walk, breathe for 10 minutes." "A patient of Brazilian origin dances... The more you have enjoyed yourself during the day, the less frustration you have, the less frustration you have, the less you want to smoke."
Four out of five will maintain their smoking cessation.
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