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so over the past 25 years weve become aware of the serious impact that alcohol and tobacco use in pregnancy can have causing a range of birth defects and lifelong disabilities and at the same time we become aware of the role of the healthcare provider in assisting women to change their alcohol and tobacco use during pregnancy using a very collaborative and respectful tailored approach to change then the interviews and commentary that will follow here are really about illustrating that role of the healthcare provider in supporting change with women Ive never been really docHub barriers on the road to identifying best practice in this area in in terms of discussing alcohol tobacco and other substance use with women during pregnancy pre pregnancy and postpartum most importantly I think the biggest challenge for us has been that theres been this persistent society-wide approach to addiction and some problem substance use so overall weve really tended to see addiction as a moral p