Alcohol, tobacco, cannabinoid, and substance use in pregnancy Quiz: Ace Your Exams

A 25-year-old woman, G1P0, who is 14 weeks pregnant, presents to the clinic for her first prenatal visit. She has no significant medical history and takes only prenatal vitamins. This is her first pregnancy, and it has been uneventful, except for mild nausea. She is currently employed as a graphic designer and lives with her partner, who does not smoke. She has been smoking half a pack of cigarettes daily for the past 5 years. She mentions several unsuccessful, unaided attempts to quit smoking in the past year, citing increased stress at work as a major trigger for her continued tobacco use. Temperature is 37.0°C (98.6°F), pulse is 72/min, respiratory rate is 18/min, and blood pressure is 120/78 mmHg. On physical examination, she is awake and alert and in no distress. Which of the following is the most appropriate question to ask next?