Reducing health inequalities through pregnancy and smoking cessation: A pragmatic pilot to reduce smoking during pregnancy
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Author(s)
Dr Lucy Hackshaw, Janet Ferguson and Professor Linda Bauld
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| Presenter(s) |
Dr Lucy Hackshaw Research Officer in Applied Health Policy Research, University of Bath / UK Centre for Tobacco Control Studies |
Abstract Smoking during pregnancy can cause substantial harm, however many women in the UK continue. Cessation interventions can be effective; however they are underused. NICE guidance, recommends that maternity services routinely employ opt out referral pathways, including CO monitoring, to help women quit. Additionally, pregnant women often underreport smoking status. We aimed to develop and pilot an integrated referral pathway for smoking cessation in pregnancy, and to test the best method to identify pregnant smokers in routine maternity care (self report (SR) v CO monitoring v cotinine testing).
The pathway was implemented at two West Midlands maternity units. On two occasions women’s SR smoking status and CO reading was recorded. Referrals to the local stop smoking service (LSSS) were automatically made for SR smokers, CO readings over 4ppm and recent quitters. Urine samples were collected for cotinine analysis.
Over 3000 women entered the pathway and over 1600 urine samples provided. Preliminary findings are that CO monitoring is now routine practice, with an increase in smoking related knowledge. Increase referrals were reported by LSSS. Early cotinine analysis suggests variation between SR, CO and cotinine outcomes. This could guide maternity units and LSSSs on how to identify and refer pregnant smokers.
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Presenter biography Lucy Hackshaw is a Health Psychologist currently working as a Research Officer in Applied Health Policy Research. Her current work explores inequalities in health and uses tobacco control and smoking cessation to try and reduce these inequalities. Lucy works specifically with Maternity Services to reduce smoking in pregnancy and with Children’s Centres to increase referrals to Local Stop Smoking Services for parents and carers in some of the most deprived areas in England. Lucy’s previous PhD research explored the implications of smoke-free legislation for NHS Stop Smoking Services.
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Source of funding: This is one of six inequalities in health pilots run under the auspices of the UK Centre for Tobacco Control Studies, funded by the Department of Health
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Declaration of interest: None
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