Anderson S Growing Up in Scotland: first research report on sweep 1 findings of the Growing Up in Scotland study.Edinburgh: Scottish Government; 2007

Bandura A. Self-efficacy mechanism in human agency. American Psychologist. 1982; 37:(2)122-147

Deming WE. Elementary principles of the statistical control of quality, JUSE. 1950;

Department of Health. Towards a smoke free generation: tobacco control plan for England. 2017. (accessed 31 Ocotber 2019)

Devries H, Backbier B. Self-efficacy as an important determinant of quitting among pregnant women who smoke: the ø-pattern. preventive medicine. 1994; 23:(2)67-174

Flemming K, Graham H, Angus K. Qualitative systematic review: barriers and facilitators to smoking cessation experienced by women in pregnancy and following childbirth. Journal of Advanced Nursing. 2015; 71:(6)1210-1226

Health Education England. Making every contact count. 2020. (accessed 20 May 2020)

Hemsing N, Greaves L, O'Leary R, Chan K, Okoli C. Partner support for smoking cessation during pregnancy: a systematic review. Nicotine and Tobacco Research. 2012; 14:(7)767-776

Koshy P. Smoking cessation during pregnancy: the influence of partners, family and friends on quitters and non-quitters. Health and Social Care in the Community. 2010; 18:(5)445-562

Miller WR, Rollnick S. Motivational interviewing: helping people change, 3rd edn. New York: Guilford Press; 2013

Mund M, Louwen F, Klingelhoefer D, Gerber A. Smoking and pregnancy: a review on the first major environmental risk factor of the unborn. International Journal of Environmental Research and Public Health. 2013; 10:(12)6485-6499

National Institute for Health Research. The ‘BabyClear’ programme helped pregnant women stop smoking in North East England. 2017. (accessed 9 November 2019)

Nuffield Trust. Smoking in pregnancy: how has the percentage of women who smoke during pregnancy changed over time?. 2019. (accessed 20 May 2020)

A-Equip – a model of clinical supervision.London2017

The Poole approach to a smoke-free pregnancy

02 June 2020
Volume 28 · Issue 6


Smoking tobacco is both a pharmacological addiction and a serious social and public health issue. Smoking cessation services for pregnant women save babies' lives and have the potential to improve the health of families and communities. Engaging with pregnant smokers and their households towards quitting smoking requires a whole-team approach. Protected time for the specialist smoking in pregnancy team and freedom to develop the service improvement approach has been key in the setting described in this paper. The approach to smoking cessation described in this paper is of the quality improvement arm within the ‘Saving babies' lives’ bundle of interventions in Poole Hospital NHS Foundation Trust. The ‘plan, study, do, act’ model is described with a description of its implementation using sequential learning, enquiry, testing and being open to new ideas and approaches. The main driver questions have been: ‘how do we reach pregnant smokers who are not motivated to quit?’ and ‘what approaches will potentiate success for this group?’

Targeted and personal support for pregnant women to stop smoking as early as possible in pregnancy is an important intervention to optimise the health of both unborn babies and their mothers, and for a number of pregnancies, prevent stillbirth. It is well-known that smoking during pregnancy is one of the most important risk factors to fetal growth and development (Mund et al, 2013). Recent UK figures show some success with national smoking rates in pregnant women dropping from just under 16% in 2006/2007 to just under 11% 10 years later (see Figure 1). The Department of Health (2017) has set a new target to reduce the prevalence of smoking in pregnancy to 6% by late 2022. This paper describes one strand of measures to reduce stillbirth in Poole Hospital NHS Foundation Trust, namely smoking cessation, as well as innovative approaches to achieving this target in a group of NHS in England. It demonstrates measures of success and how innovation and research are tackling the wider determinants of maternity services users' smoking behaviours. A single new project in one trust is also described.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month