Integrating a clinical model of smoking cessation into antenatal care

Abstract

Smoking rates during pregnancy in Rotherham are high, and between 2007 and 2010 were on an upward trend. Previous local initiatives to address the problem, such as introducing an opt-out pathway and incentive schemes, were not proving effective. In early 2010 NHS Rotherham undertook a major service redesign of the smoking in pregnancy pathway, embedding intensive specialist smoking cessation advice into routine antenatal care. The proportion of pregnant women smokers who set a quit date increased from 33.7% in 2008/09 to 43.9% in 2010/11 (P < 0.05). The percentage of women still smoking at the time of delivery had initially been on an upward trend since 2006/07, reaching a high of 27.3% during 2009/10. This trend has now reversed, falling to 22.4% during 2010/11 and to 19.3% in the first quarter of 2011/12. Embedding stop smoking advice in routine antenatal care has enabled more women to receive a single intensive stop smoking intervention. It has succeeded in engaging women who attend their antenatal scans but have little other interaction with health services. The pathway is achieving better outcomes without requiring additional resources.