Smoking in pregnancy: Supporting pregnant women and extended family to quit and stay quit
Presenters: David Phelan, Colm O’Connor, Health Service Executive
Other Authors: Kate Cassidy, Health Service Executive
Introduction
Smoking in pregnancy is strongly socially patterned with age and socioeconomic factors including employment,
social class and deprivation status acting as key determinants of smoking prevalence. Socioeconomic inequalities
in smoking during pregnancy have persisted. Engaging with pregnant smokers and their households requires a
whole-team approach. This project supported pregnant women to quit smoking as early as possible during the
first trimester of pregnancy and stay smoke-free after birth by implementing an integrated cessation service.
Multidisciplinary teams across SEHC (South East Community Healthcare) working with pregnant women were trained
in Making Every Contact Count (MECC). Breath Carbon Monoxide (BCO) testing during antenatal care, combined with
‘opt-out’ referral for the pregnant women was also implemented unless the woman objected.
• The flexibility and adaptability of The ‘Plan, Do, Check, and Act (PDCA)’ cycle were utilised to ensure our
project was a Quality Improvement Initiative
• A co-designed methodology ensured participants were consulted and involved
• The impact of ‘opt-out’ referrals for pregnant smokers to Intensive Smoking Cessation Services were
monitored following BCO training and implementation.
Method
• 4-weeks quit rates were 78% rates exceed the national 4-week quit rate, which is set at 45%
• Using BCO testing during antenatal care, combined with ‘opt-out’ referral to smoking cessation services,
increased referrals two-fold
• One hundred smoke free babies born.
Results
• Delivering the Right Care at the Right time in the Right Place delivers the Right Result
• Non-judgmental service are important.
Practical/Social/Research Implications
This project is demonstrating exciting results with quit rates way above that of any comparable group. Results offers
a tobacco control model for the HSE services. The project is uniquely placed to implement intensive stop smoking
interventions as part of a best practice model across all of maternity care nationally.
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