Reducing smoking in pregnancy: evidence-backed innovation

Posted by Andrea on Friday 9th December 2016

Andrea Crossfield talks through evidence based schemes to help reduce smoking in pregnancy, proven to save lives and money.

As we are all aware the need to reduce pressure and demand on the NHS is more important than ever. Every day seems to bring stories in the media about the strain our NHS is under.

Local areas are doing good work to reduce smoking, yet are still faced with the challenge of how to increase the number of pregnant women successfully quitting smoking and improving the long term success rate of those making a quit attempt through to delivery and into the baby's first year. The previous Tobacco Plan ambition was to reduce smoking at the time of delivery (SATOD) to 11% or less by 2015 and while this was met nationally and rates of smoking in pregnancy are declining steadily, they are not falling fast enough in our most deprived communities or in vulnerable groups.

We have worked with many local authorities across the country and evidence from our schemes demonstrate that incentives offer an effective solution to supporting vulnerable women to quit and stay quit during pregnancy.

A Cochrane review indicated that the use of financial incentives provides a substantial return on investment, equating to up to £4 saved for every £1 spent on the intervention. A recent Scottish randomised controlled trial also provides substantial evidence for the efficacy of incentives for smoking cessation in pregnancy.

We want to highlight the positive results across the country we are having with our Supporting a Smokefree Pregnancy Scheme which offers small financial incentives (shopping vouchers), alongside enhanced stop smoking support services to increase the proportion of women who are smokefree during their pregnancy and post-partum.

The independent evaluation of our innovative evidenced based, Supporting a Smokefree Pregnancy Scheme, shows it is an effective solution in reducing the number of women who smoke during pregnancy. Over a thousand women have been through the scheme, 82% of the women enrolled achieved a four-week quit, with 66% remaining quit at time of delivery.

The odds of achieving a four-week quit for these women were increased by 55% when they received support from a significant other. The schemes have also been successful in having a very positive influence on partners quitting and significantly increasing smokefree homes.

We understand there can be some initial resistance to incentives, and concerns about sensational media headlines which in our experience rarely materialise when the media recognise the cost benefits. Incentive schemes, when delivered in the right way have the potential to be really powerful. They work. This means they save Trusts money – one single difficult pregnancy alone can cost £12,000 – but more importantly they save innocent lives.

And when used alongside interventions for professionals, such as babyClear which provides training and resources to front-line staff, supporting a quality, structured pathway for pregnant women to receive stop smoking support, incentives have the potential to be even more powerful.

babyClear increases CO screening, trains midwives to deliver more intensive interventions to pregnant women who continue to smoke, increases skills of stop smoking advisors and administrative staff on how to convert pregnancy leads and also offers a range of materials.

The implementation of babyClear reduces the number of women who smoke opting not to be referred to smoking cessation to about 5%, with over 50% of those identified as smokers making contact with smoking cessation services following identification and a midwifery led brief intervention.

With such stress on the NHS, now is the time to look for evidence-backed innovation that has been proven to save lives and money.

If you are facing similar challenges in your locality read our independent review and get in touch with us to see how we can support you through our Supporting a Smokefree Pregnancy Scheme, or contact iPiP for more information about babyClear.

Read more about our smokefree pregnancy schemes here.

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Healthier Futures CIC is a social enterprise and our mission is to help people live longer, healthier, happier lives. We do this by; making smoking history for children; creating communities free from alcohol harm and empowering communities to live longer, healthier, happier lives.

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