Introducing ‘opt-out’ referrals for pregnant women to stop smoking services: Impact on service uptake and smoking cessation
Author(s)
Katarzyna Campbell, Sue Cooper and Tim Coleman
Presenter(s)
Katarzyna Campbell Research Fellow, Division of Primary Care, University of Nottingham
Abstract
‘Opt-out’ referrals for NHS support by stop smoking services (SSS) are recommended by NICE. These involve identifying pregnant smokers using exhaled carbon monoxide (CO) and referring them for support unless they request otherwise.
Aim
To assess impacts of ‘opt-out’ referrals for pregnant smokers on SSS uptake and effectiveness
Methods
This was a ‘before–after’ service evaluation in a hospital trust; in the ‘before’ period, there was already an ‘opt-in’ referral system for self-reported smokers at antenatal booking appointments (approximately 9 weeks gestation). In the ‘after’ period, ‘opt-out’ referrals were introduced at ultrasound scan appointments (week 12); women with CO≥4ppm were referred and outcome data were collected from the local SSS.
Results
Approximately 2300 women attended antenatal care in each period. ‘Before’, 2.5% of these set a quit date (95% CI, 1.9% to 3.2%) and ‘after’ this increased to 5.3% (95% CI, 4.4% to 6.3%). Similarly, self-reported abstinence was 2.0% (95% CI, 1.5% to 2.7%) before and 4.1% (95% CI, 3.3% to 4.9%) after opt-out referrals were introduced.
Conclusions
In a hospital that already had an ‘opt-in’ referral system, adding CO monitoring with ‘opt-out’ referrals, doubled numbers of pregnant smokers setting quit dates and reporting smoking cessation.
Source of funding: National Institute for Health Research
