Smoking (commercial tobacco use) during pregnancy is the most important modifiable risk factor linked to adverse pregnancy and long-term health outcomes for both mother and child.  In Canada and worldwide, there is a higher prevalence of commercial tobacco use among perinatal Indigenous women, which is linked to a number of Indigenous and social determinants of health, including colonization. It is likely that most health providers have (or will) encounter Indigenous persons in their daily practice.

Identifying respectful strategies to effectively reduce commercial tobacco use with perinatal Indigenous women and persons is a health system priority. Understanding the many complexities that influence the use of commercial tobacco in Indigenous persons of reproductive age is essential for all health providers and students entering health professions. 

This BPG provides nurses and other members of the circle of care with evidence-based recommendations to help create and promote Indigenous-led smoking reduction and cessation services that are culturally safe. The recommendations include offering smoking cessation counselling, Indigenous health and cultural safety education for health providers, conducting advocacy for access to relevant resources and promoting smoke-free spaces.

This BPG – aimed at meeting the needs of Indigenous women and peoples of reproductive age, their support networks and communities – can be used by nurses and members of the circle of care in primary care, community care and maternal/child settings, and in all domains of practice (for example, administration, clinical, education, policy and research). It can also be used by organizations that employ nurses and members of the circle of care, including health- and social-service organizations and academic settings.