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Shoaib Malik MD

  • Graduate 2017
Scholarly Research Project

Using the Carbon Monoxide Monitor as a tool for Smoking Cessation in Pregnancy

Shoaib Malik MD, Rowena Pingul-Ravano MD, FAAFP, Schlar, Lisa MD
University of Pittsburgh Medical Center Shadyside Family Medicine Residency, Pittsburgh, Pennsylvania


Smoking contributes to 20% of small-for-gestational age babies and 8% of preterm births, because carbon monoxide from cigarette smoking decreases oxygenation of the fetus in utero. We attempted to determine if a carbon monoxide (CO) monitor could be useful to encourage pregnant and post-partum patients with smoking cessation.


Physicians at the UPMC Shadyside Family Health Center (SHY FHC) were encouraged to check CO levels using the CO monitor in all prenatal or post-partum visits in a 45-day period, regardless of smoking status, and document results in the EMR. Chart review, conducted post-intervention, tallied usage of the CO monitor, compared CO results with smoking status, and compared CO results in smokers at subsequent office visits.


During the 45-day study period, the CO monitor was used in 10 out of 45 (22%) prenatal or post-partum visits. Of those 10 encounters, all patients reported non-smoking status and one patient acknowledged second hand smoke exposure.  All scores were consistent with the patient’s reported smoking status and were below positive CO threshold scores.


We anticipate that our project will assist in making CO monitoring common practice in smoking cessation counseling in pregnancy.  Limitations to our study included small population sample, short duration of study, equipment malfunction and inconsistent provider documentation. More research is indicated to identify how to address these limitations.