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Postnatal smoking cessation advice: A reflective case study

02 May 2017
Volume 25 · Issue 5


In the antenatal period, smoking cessation is a key health promotion topic for midwives due to the recognised adverse outcomes. Carbon monoxide screening and locally available referral pathways demonstrate the wide availability of support for women who smoke when pregnant. However, there is arguably less health promotion provided to women in the postnatal period, due to minimal research. Reflecting on a case study throughout, this article analyses the health promotion provided by midwives to women about postpartum smoking and its effects, exploring the risks to the newborn, particularly highlighting the relationship between smoking and breastfeeding. There will be reference made to what is implemented in the local area of Hertfordshire to assist in smoking cessation, comparing both national and local policies. There is a great emphasis on the fundamental role of the midwife in providing health promotion, assessing the suitable environment and communication skills to ensure effectiveness.

Health promotion is defined by the World Health Organisation (WHO) (2016) as enabling others to have control of their health. Indeed, Naidoo and Willis (2000) state that health promotion is providing people with education of the necessary skills to instil confidence to make health changes. Midwives have a duty to promote wellbeing and empower women to make positive changes and decisions concerning their health (Nursing and Midwifery Council (NMC), 2015). Smoking, according to Public Health England (PHE) (2014), is England's biggest cause of mortality and ill health, resulting in 80,000 premature deaths a year. This article will examine smoking in terms of health promotion, reflecting on a scenario that occurred within the community setting. It will follow the structure of the Circular Transactional Model (Arnold and Boggs, 2011). This model acknowledges communication is dyadic and therefore should be reciprocal (Pagano and Ragan, 1992). To provide confidentiality, the service user in the incident will be known by the pseudonym of Sarah; the trust will be referred to as Trust A (NMC, 2015).

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