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Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Provision of smoking cessation support for pregnant women in England: results from an online survey of NHS stop smoking services for pregnant women

Authors: Samantha J Fahy, Sue Cooper, Tim Coleman, Felix Naughton, Linda Bauld

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). However, to date, little is known of how these services provide support across England. The aim of this study was to describe the key elements of support provided through English SSSP.

Methods

SSSP managers were invited to participate in this survey by email. Data were then collected via an online questionnaire; one survey was completed for each SSSP. Up to four reminder emails were sent over a two month period.

Results

86% (121 of 141) of services completed the survey. Responding services were, on average, larger than non-responding services in terms of the number of pregnant women setting quit dates and successfully quitting (p < 0.01). In line with the 2010 NICE guidelines, Stop Smoking in Pregnancy and following Childbirth, one in five SSSP identified pregnant smokers using carbon monoxide (CO) testing and refer via an opt-out pathway. All services offered nicotine replacement therapy (NRT) to pregnant women and 87% of services also offered dual therapy NRT, i.e. combination of a patch and short acting NRT product.. The 2010 NICE guidelines note that services should be flexible and client-centred. Consistent with this, SSSP offer pregnant women a range of support types (median 4) including couple/family, group (open or closed) or one-to-one. These are available in a number of locations (median 5), including in community venues, clinics and women’s homes.

Conclusions

English Stop Smoking Services offer behavioural support and pharmacotherapy to pregnant women motivated to quit smoking. Interventions provided are generally evidence-based and delivered in a variety of both social and health care settings.
Literature
2.
go back to reference Bloch M, Althabe F, Onyamboko M, Kaseba-Sata C, Castilla EE, Freire S, Garces AL, Parida S, Goudar SS, Kadir MM, Goco N, Thornberry J, Daniels M, Bartz J, Hartwell T, Moss N, Goldenberg R: Tobacco use and secondhand smoke exposure during pregnancy: an investigative survey of women in 9 developing nations. Am J Public Health. 2008, 98 (10): 1833-1840. 10.2105/AJPH.2007.117887.CrossRefPubMedPubMedCentral Bloch M, Althabe F, Onyamboko M, Kaseba-Sata C, Castilla EE, Freire S, Garces AL, Parida S, Goudar SS, Kadir MM, Goco N, Thornberry J, Daniels M, Bartz J, Hartwell T, Moss N, Goldenberg R: Tobacco use and secondhand smoke exposure during pregnancy: an investigative survey of women in 9 developing nations. Am J Public Health. 2008, 98 (10): 1833-1840. 10.2105/AJPH.2007.117887.CrossRefPubMedPubMedCentral
3.
go back to reference Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L: Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2009, 3: CD001055.PubMed Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L: Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2009, 3: CD001055.PubMed
4.
go back to reference Al-Sahab B, Saqib M, Hauser G, Tamim H: Prevalence of smoking during pregnancy and associated risk factors among Canadian women: a national survey. BMC Pregnancy Childbirth. 2010, 10: 24-10.1186/1471-2393-10-24.CrossRefPubMedPubMedCentral Al-Sahab B, Saqib M, Hauser G, Tamim H: Prevalence of smoking during pregnancy and associated risk factors among Canadian women: a national survey. BMC Pregnancy Childbirth. 2010, 10: 24-10.1186/1471-2393-10-24.CrossRefPubMedPubMedCentral
5.
go back to reference Kaneita Y, Tomofumi S, Takemura S, Suzuki K, Yokoyama E, Miyake T, Harano S, Ibuka E, Kaneko A, Tsutsui T, Ohida T: Prevalence of smoking and associated factors among pregnant women in Japan. Prev Med. 2007, 45 (1): 15-20. 10.1016/j.ypmed.2007.04.009.CrossRefPubMed Kaneita Y, Tomofumi S, Takemura S, Suzuki K, Yokoyama E, Miyake T, Harano S, Ibuka E, Kaneko A, Tsutsui T, Ohida T: Prevalence of smoking and associated factors among pregnant women in Japan. Prev Med. 2007, 45 (1): 15-20. 10.1016/j.ypmed.2007.04.009.CrossRefPubMed
6.
go back to reference Tong VJ JR, Dietz PM, D’Angelo D, Bombard JM: Trends in smoking before, during, and after pregnancy — Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 31 Sites, 2000–2005. Morb Mortal Wkly Rep. 2009, 58 (S-4): 1-36. Tong VJ JR, Dietz PM, D’Angelo D, Bombard JM: Trends in smoking before, during, and after pregnancy — Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 31 Sites, 2000–2005. Morb Mortal Wkly Rep. 2009, 58 (S-4): 1-36.
7.
go back to reference Ruiz CAJ: Nicotine replacement therapy during pregnancy. Arch Bronconeumol. 2006, 42 (8): 404-409. 10.1157/13091650.CrossRef Ruiz CAJ: Nicotine replacement therapy during pregnancy. Arch Bronconeumol. 2006, 42 (8): 404-409. 10.1157/13091650.CrossRef
9.
go back to reference Mohsin M, Bauman AE, Forero R: Socioeconomic correlates and trends in smoking in pregnancy in New South Wales, Australia. J Epidemiol Community Health. 2011, 65 (8): 727-732. 10.1136/jech.2009.104232.CrossRefPubMed Mohsin M, Bauman AE, Forero R: Socioeconomic correlates and trends in smoking in pregnancy in New South Wales, Australia. J Epidemiol Community Health. 2011, 65 (8): 727-732. 10.1136/jech.2009.104232.CrossRefPubMed
10.
go back to reference Erickson AC, Arbour LT: Heavy smoking during pregnancy as a marker for other risk factors of adverse birth outcomes: a population-based study in British Columbia, Canada. BMC Public Health. 2012, 12: 102-10.1186/1471-2458-12-102.CrossRefPubMedPubMedCentral Erickson AC, Arbour LT: Heavy smoking during pregnancy as a marker for other risk factors of adverse birth outcomes: a population-based study in British Columbia, Canada. BMC Public Health. 2012, 12: 102-10.1186/1471-2458-12-102.CrossRefPubMedPubMedCentral
11.
go back to reference Hajek P, West R, Lee A, Foulds J, Owen L, Eiser JR, Main N: Randomized controlled trial of a midwife-delivered brief smoking cessation intervention in pregnancy. Addiction. 2001, 96 (3): 485-494. 10.1046/j.1360-0443.2001.96348511.x.CrossRefPubMed Hajek P, West R, Lee A, Foulds J, Owen L, Eiser JR, Main N: Randomized controlled trial of a midwife-delivered brief smoking cessation intervention in pregnancy. Addiction. 2001, 96 (3): 485-494. 10.1046/j.1360-0443.2001.96348511.x.CrossRefPubMed
12.
go back to reference Cooke M, Mattick RP, Barclay L: Predictors of brief smoking intervention in a midwifery setting. Addiction. 1996, 91 (11): 1715-1725. 10.1111/j.1360-0443.1996.tb02274.x.CrossRefPubMed Cooke M, Mattick RP, Barclay L: Predictors of brief smoking intervention in a midwifery setting. Addiction. 1996, 91 (11): 1715-1725. 10.1111/j.1360-0443.1996.tb02274.x.CrossRefPubMed
13.
go back to reference McDermott MS, Thomson H, West R, Kenyon JA, McEwen A: Translating evidence-based guidelines into practice: a survey of practices of commissioners and managers of the English stop smoking services. BMC Health Serv Res. 2012, 12: 121-10.1186/1472-6963-12-121.CrossRefPubMedPubMedCentral McDermott MS, Thomson H, West R, Kenyon JA, McEwen A: Translating evidence-based guidelines into practice: a survey of practices of commissioners and managers of the English stop smoking services. BMC Health Serv Res. 2012, 12: 121-10.1186/1472-6963-12-121.CrossRefPubMedPubMedCentral
16.
go back to reference NICE: Quitting smoking in pregnancy and following childbirth. NICE Public Health Guid. 2010, 26: 1-58. NICE: Quitting smoking in pregnancy and following childbirth. NICE Public Health Guid. 2010, 26: 1-58.
17.
go back to reference West R: ‘Payment by results’ and smoking cessation support. Addiction. 2011, 106 (10): 1730-1731. 10.1111/j.1360-0443.2011.03541.x.CrossRefPubMed West R: ‘Payment by results’ and smoking cessation support. Addiction. 2011, 106 (10): 1730-1731. 10.1111/j.1360-0443.2011.03541.x.CrossRefPubMed
19.
go back to reference Wyatt S: Payment by results can increase the availability of smoking cessation services while improving quality and equity. Addiction. 2012, 107 (1): 226-227. 10.1111/j.1360-0443.2011.03683.x. author reply 227–228CrossRefPubMed Wyatt S: Payment by results can increase the availability of smoking cessation services while improving quality and equity. Addiction. 2012, 107 (1): 226-227. 10.1111/j.1360-0443.2011.03683.x. author reply 227–228CrossRefPubMed
22.
go back to reference Ferguson J, Bauld L, Chesterman J, Judge K: The English smoking treatment services: one-year outcomes. Addiction. 2005, 100: 59-69.CrossRefPubMed Ferguson J, Bauld L, Chesterman J, Judge K: The English smoking treatment services: one-year outcomes. Addiction. 2005, 100: 59-69.CrossRefPubMed
23.
go back to reference Bauld L, Hackshaw L, Ferguson J, Coleman T, Taylor G, Salway R: Implementation of routine biochemical validation and an ‘opt out’ referral pathway for smoking cessation in pregnancy. Addiction. 2012, 107 (Suppl 2): 53-60.CrossRefPubMed Bauld L, Hackshaw L, Ferguson J, Coleman T, Taylor G, Salway R: Implementation of routine biochemical validation and an ‘opt out’ referral pathway for smoking cessation in pregnancy. Addiction. 2012, 107 (Suppl 2): 53-60.CrossRefPubMed
24.
go back to reference Ashwin CA, Watts K: Women’s use of nicotine replacement therapy in pregnancy-a structured review of the literature. Midwifery. 2010, 26 (3): 304-310. 10.1016/j.midw.2008.08.002.CrossRefPubMed Ashwin CA, Watts K: Women’s use of nicotine replacement therapy in pregnancy-a structured review of the literature. Midwifery. 2010, 26 (3): 304-310. 10.1016/j.midw.2008.08.002.CrossRefPubMed
25.
go back to reference Lee M, Hajek P, McRobbie H, Owen L: Best practice in smoking cessation services for pregnant women: results of a survey of three services reporting the highest national returns, and three beacon services. J R Soc Promot Health. 2006, 126 (5): 233-238. 10.1177/1466424006068241.CrossRefPubMed Lee M, Hajek P, McRobbie H, Owen L: Best practice in smoking cessation services for pregnant women: results of a survey of three services reporting the highest national returns, and three beacon services. J R Soc Promot Health. 2006, 126 (5): 233-238. 10.1177/1466424006068241.CrossRefPubMed
26.
go back to reference Javors MA, Hatch JP, Lamb RJ: Sequential combination of self-report, breath carbon monoxide, and saliva cotinine to assess smoking status. Drug Alcohol Depend. 2011, 113 (2–3): 242-244.CrossRefPubMed Javors MA, Hatch JP, Lamb RJ: Sequential combination of self-report, breath carbon monoxide, and saliva cotinine to assess smoking status. Drug Alcohol Depend. 2011, 113 (2–3): 242-244.CrossRefPubMed
27.
go back to reference Martı́nez ME, Reid M, Jiang R, Einspahr J, Alberts DS: Accuracy of self-reported smoking status among participants in a chemoprevention trial. Prev Med. 2004, 38 (4): 5. Martı́nez ME, Reid M, Jiang R, Einspahr J, Alberts DS: Accuracy of self-reported smoking status among participants in a chemoprevention trial. Prev Med. 2004, 38 (4): 5.
28.
go back to reference Shipton D, Tappin DM, Vadiveloo T, Crossley JA, Aitken DA, Chalmers J: Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study. BMJ. 2009, 339: b4347-10.1136/bmj.b4347.CrossRefPubMedPubMedCentral Shipton D, Tappin DM, Vadiveloo T, Crossley JA, Aitken DA, Chalmers J: Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study. BMJ. 2009, 339: b4347-10.1136/bmj.b4347.CrossRefPubMedPubMedCentral
29.
go back to reference Usmani ZC, Craig P, Shipton D, Tappin D: Comparison of CO breath testing and women’s self-reporting of smoking behaviour for identifying smoking during pregnancy. Subst Abuse Treat Prev. 2008, 3: 4-10.1186/1747-597X-3-4. doi:10.1186/1747-597X-3-4CrossRef Usmani ZC, Craig P, Shipton D, Tappin D: Comparison of CO breath testing and women’s self-reporting of smoking behaviour for identifying smoking during pregnancy. Subst Abuse Treat Prev. 2008, 3: 4-10.1186/1747-597X-3-4. doi:10.1186/1747-597X-3-4CrossRef
30.
go back to reference Benowitz NL: Nicotine replacement therapy during pregnancy. JAMA. 1991, 266 (22): 3174-3177. 10.1001/jama.1991.03470220090034.CrossRefPubMed Benowitz NL: Nicotine replacement therapy during pregnancy. JAMA. 1991, 266 (22): 3174-3177. 10.1001/jama.1991.03470220090034.CrossRefPubMed
31.
go back to reference Benowitz N, Dempsey D: Pharmacotherapy for smoking cessation during pregnancy. Nicotine Tob Res. 2004, 6 (Suppl 2): S189-S202.CrossRefPubMed Benowitz N, Dempsey D: Pharmacotherapy for smoking cessation during pregnancy. Nicotine Tob Res. 2004, 6 (Suppl 2): S189-S202.CrossRefPubMed
32.
go back to reference Coleman T, Cooper S, Thornton JG, Grainge MJ, Watts K, Britton J, Lewis S: A randomized trial of nicotine-replacement therapy patches in pregnancy. N Engl J Med. 2012, 366 (9): 808-818. 10.1056/NEJMoa1109582.CrossRefPubMed Coleman T, Cooper S, Thornton JG, Grainge MJ, Watts K, Britton J, Lewis S: A randomized trial of nicotine-replacement therapy patches in pregnancy. N Engl J Med. 2012, 366 (9): 808-818. 10.1056/NEJMoa1109582.CrossRefPubMed
33.
go back to reference Oncken C, Dornelas E, Greene J, Sankey H, Glasmann A, Feinn R, Kranzler HR: Nicotine gum for pregnant smokers: a randomized controlled trial. Obstet Gynecol. 2008, 112 (4): 859-867. 10.1097/AOG.0b013e318187e1ec.CrossRefPubMedPubMedCentral Oncken C, Dornelas E, Greene J, Sankey H, Glasmann A, Feinn R, Kranzler HR: Nicotine gum for pregnant smokers: a randomized controlled trial. Obstet Gynecol. 2008, 112 (4): 859-867. 10.1097/AOG.0b013e318187e1ec.CrossRefPubMedPubMedCentral
34.
go back to reference Coleman T, Chamberlain C, Davey M-A, Cooper SE, Leonardi-Bee J: Pharmacological interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2012, 9: CD010078-doi:10.1002/14651858PubMed Coleman T, Chamberlain C, Davey M-A, Cooper SE, Leonardi-Bee J: Pharmacological interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2012, 9: CD010078-doi:10.1002/14651858PubMed
35.
go back to reference Fish LJ, Peterson BL, Namenek Brouwer RJ, Lyna P, Oncken CA, Swamy GK, Myers ER, Pletsch PK, Pollak KI: Adherence to nicotine replacement therapy among pregnant smokers. Nicotine Tob Res. 2009, 11 (5): 514-518. 10.1093/ntr/ntp032.CrossRefPubMedPubMedCentral Fish LJ, Peterson BL, Namenek Brouwer RJ, Lyna P, Oncken CA, Swamy GK, Myers ER, Pletsch PK, Pollak KI: Adherence to nicotine replacement therapy among pregnant smokers. Nicotine Tob Res. 2009, 11 (5): 514-518. 10.1093/ntr/ntp032.CrossRefPubMedPubMedCentral
36.
go back to reference Coleman T, Chamberlain C, Cooper S, Leonardi-Bee J: Efficacy and safety of nicotine replacement therapy for smoking cessation in pregnancy: systematic review and meta-analysis. Addiction. 2011, 106 (1): 52-61. 10.1111/j.1360-0443.2010.03179.x.CrossRefPubMed Coleman T, Chamberlain C, Cooper S, Leonardi-Bee J: Efficacy and safety of nicotine replacement therapy for smoking cessation in pregnancy: systematic review and meta-analysis. Addiction. 2011, 106 (1): 52-61. 10.1111/j.1360-0443.2010.03179.x.CrossRefPubMed
38.
go back to reference Ussher M, West R, Hibbs N: A survey of pregnant smokers’ interest in different types of smoking cessation support. Patient Educ Couns. 2004, 54 (1): 67-72. 10.1016/S0738-3991(03)00197-6.CrossRefPubMed Ussher M, West R, Hibbs N: A survey of pregnant smokers’ interest in different types of smoking cessation support. Patient Educ Couns. 2004, 54 (1): 67-72. 10.1016/S0738-3991(03)00197-6.CrossRefPubMed
Metadata
Title
Provision of smoking cessation support for pregnant women in England: results from an online survey of NHS stop smoking services for pregnant women
Authors
Samantha J Fahy
Sue Cooper
Tim Coleman
Felix Naughton
Linda Bauld
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-107

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