BACKGROUND Evidence suggests that cigarette smoking and alcohol consumption during pregnancy negatively impacts fetal health. Health agencies across countries have developed specific guidelines for health professionals in perinatal care to strengthen their role in smoking and alcohol use prevention. One such example is the "Guideline on Screening and Counselling for prevention of cigarette smoking and alcohol consumption before, during, and after pregnancy" introduced by the Swiss Midwives Association in 2011. The current study assesses the changes in midwives' engagement in smoking and alcohol use prevention before (2008) and after the introduction of the Guideline (2018). Further, the current study examines differences across regions (German vs. French speaking regions), graduation years (before and after the introduction of the Guideline) and different work settings (hospital vs. self-employed). METHODS Survey data were collected in 2008 (n = 366) and in 2018 (n = 459). Differences in how midwives engaged in smoking and alcohol use prevention between 2008 and 2018 were assessed with chi-square tests, as were differences across German and French speaking regions, graduation years (before and after the introduction of the Guideline) and across different work settings (working in hospitals or as self-employed). RESULTS An increase in midwives' awareness of the risks of consuming even small quantities of cigarettes and alcohol for the unborn child between 2008 and 2018 is evident. Explaining the risks to pregnant women who smoke or use alcohol remained the most frequently reported prevention strategy. However, engagement with more extensive smoking and alcohol use preventive strategies across the whole course of pregnancy, such as assisting women in the elaboration of a plan to stop smoking/alcohol use, remained limited. CONCLUSIONS Seven years after its introduction, the effectiveness of the Guideline in increasing midwives' engagement in smoking and alcohol use prevention appears limited despite midwives' increased awareness.

中文翻译：

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助产士在瑞士引入行医指南之前和之后在产前保健中预防吸烟和饮酒：比较2008年和2018年的调查结果。

背景技术有证据表明，怀孕期间吸烟和饮酒会对胎儿健康产生负面影响。各个国家的卫生机构都为围产期保健中的卫生专业人员制定了具体的指南，以加强其在预防吸烟和饮酒中的作用。其中一个例子是瑞士助产士协会于2011年推出的“预防和预防怀孕前，怀孕中和怀孕后吸烟的指南和咨询指南”。当前的研究评估了助产士对吸烟和酗酒的参与程度的变化。指南（2018年）出台之前和之后（2018年）使用预防措施。此外，本研究调查了跨地区（德语与法语地区）的差异，毕业年份（在引入指南之前和之后）和不同的工作环境（医院与自雇人士）。方法调查数据收集于2008年（n = 366）和2018年（n = 459）。通过卡方检验评估了2008年至2018年助产士在预防吸烟和饮酒方面的差异，德语和法语地区，毕业年份（《指南》出台前后）以及不同工作环境之间的差异也得到了评估。 （在医院工作或自雇）。结果显然，助产士对未出生的孩子在2008年至2018年间消费少量香烟和酒精的风险的意识有所提高。向吸烟或喝酒的孕妇解释风险仍然是最常报告的预防策略。然而，在整个怀孕过程中参与更广泛的吸烟和饮酒预防策略的参与仍然有限，例如协助妇女制定戒烟/饮酒计划。结论实施指南七年后，尽管助产士意识有所提高，但该指南在提高助产士参与预防吸烟和饮酒方面的有效性似乎有限。