Abatemarco DJ, Steinberg MB, Delnevo CD Midwives' knowledge, perceptions, beliefs, and practice supports regarding tobacco dependence treatment. J Midwifery Womens Health. 2007; 52:(5)451-7

Beenstock J, Sniehotta FF, White M, Bell R, Milne EM, Araujo-Soares V What helps and hinders midwives in engaging with pregnant women about stopping smoking? A cross-sectional survey of perceived implementation difficulties among midwives in the North East of England. Implement Sci. 2012; 7:(36)

Bonellie SR Effect of maternal age, smoking and deprivation on birthweight. Paediatr Perinat Epidemiol. 2001; 15:(1)19-26

Braun V, Clarke V Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:(2)77-101

Leicester: British Psychological Society; 2009

Centers for Disease Control and Prevention. Smoking during pregnancy. 2014. (accessed 10 December 2015)

Croghan ELondon: Department of Health; 2011

McEwen A, 2nd edn. London: National Centre for Smoking Cessation Training and Research; 2015

London: NCSCT; 2012

National Institute for Health and Care Excellence. Smoking: Brief interventions and referrals. 2006. (accessed 10 December 2015)

National Institute for Health and Care Excellence. Stop smoking services. 2008. (accessed 10 December 2015)

National Institute for Health and Care Excellence. Smoking: stopping in pregnancy and after childbirth. 2010. (accessed 10 December 2015)

National Institute for Health and Care Excellence. Smoking: acute, maternity and mental health services. 2013. (accessed 10 December 2015)

Office for National Statistics. Opinions and Lifestyle Survey, Adult Smoking Habits in Great Britain, 2013. 2014. (accessed 10 December 2015)

Prabhu N, Smith N, Campbell D, Craig LC, Seaton A, Helms PJ, Devereux G, Turner SW First trimester maternal tobacco smoking habits and fetal growth. Thorax. 2010; 65:(3)235-40

Randall S Midwives' attitudes to smoking and smoking cessation in pregnancy. British Journal of Midwifery. 2009; 17:(10)642-46

London: Royal College of Physicians; 2010

Smith JALondon: SAGE Publications; 2008

West R Smoking cessation and pregnancy. Fetal Maternal Med Review. 2002; 13:(3)181-94

Talking about smoking cessation with pregnant women: Exploring midwives' accounts

02 January 2016
Volume 24 · Issue 1


The aim of the current study was to use interviews to explore midwives' experiences of talking to pregnant women about smoking cessation. Eight midwives based in one UK hospital took part in face-to-face semi-structured interviews. Thematic analysis revealed that midwives were aware of health risks associated with smoking, saw providing smoking cessation advice as part of their role, would value more support from GPs, and were clear that support and a woman-centred approach were key. Failure to refer women for support was related to cumbersome or misunderstood referral procedures rather than reluctance to refer.

It is estimated that 11% of women in the UK smoke during pregnancy (Office for National Statistics, 2014). Smoking is recognised as a significant predictor for adverse outcomes in pregnancy, increased risk of intrauterine growth restriction and premature birth (Royal College of Physicians, 2010; Centers for Disease Control and Prevention, 2014).

In the UK, National Institute for Health and Care Excellence (NICE) guidelines recommend that all pregnant women are advised to stop smoking and referred for stop-smoking support (NICE, 2008; 2010; 2013). However, midwives vary in their level of adherence to clinical guidelines for helping pregnant smokers to quit (Abatemarco et al, 2007) and may be unwilling to address smoking cessation with women in antenatal visits, possibly believing that their relationship with a woman could suffer if they did so (Randall, 2009).

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