Les professionnels de maternités se mobilisent contre le tabagisme au cours de la grossesse. Évaluation du programme Picard

The aim is to assess the improvement process following a regional campaign against smoking during pregnancy and to analyse the requirements. A practice survey was carried out nine to twelve months after the training. More than half the midwives and more than a third of doctors are involved and deliver an adapted message. The large maternity hospitals are less involved than the others. Sixteen of the eighteen maternity hospitals report an improvement in treatment and a general improvement process but they all report difficulties (structural problems, nicotine substitute treatment, training, etc), deemed important in half of the cases. There are insufficient human and financial resources to deal with this (training, distribution of practical tools, access to nicotine substitutes, provision of scanners). The programme is a success thanks to an informal, but extremely functional, network of professional midwives. The process undertaken by healthcare professionals to improve treatment needs to be accompanied by sustainable financing of the supervisory bodies, since Public Health activities are not promoted by the activity-based payment system.