Smoking During Pregnancy and Smoking Cessation Services

Abstract

BackgroundObtaining accurate figures on the extent of smoking during pregnancy is a challenge in many countries, and the United Kingdom is no exception. Prevalence figures in the United Kingdom are drawn from the infant feeding survey, which is conducted infrequently (every 5 years) and relies on self-report data collected from women following delivery (Information Centre, 2007). The survey asks two main questions about smokingwhether women have smoked in the 12 months before or during pregnancy, and whether they have smoked throughout pregnancy.Findings from the most recent survey (2005) show that smoking rates throughout pregnancy varied across the UK from 22% in Wales to 20% in Scotland and 18% in Northern Ireland, with the rate for England and the UK overall at 17%. This represents a decline from the UK average of 20% recorded by the same survey in 2000. However, smoking rates differ significantly depending on the age and socio-economic status of the pregnant woman. For example, pregnant mothers who are 20 or under are more than three times as likely to smoke before or during pregnancy as mothers aged 35 or over.In addition, mothers in routine and manual occupations are more than four times as likely as those in managerial and professional occupations to have smoked throughout pregnancy (29% and 7% respectively). What is of particular concern is that comparisons between 2000 and 2005 by socio-economic group in England show a slight increase in smoking throughout pregnancy for routine and manual groups, suggesting that inequalities in this area may be increasing rather than reducing (Information Centre, 2007).Governments have used the infant feeding survey figures as the basis for targets to reduce smoking during pregnancy, particularly in England where the main target is to reduce the rate of smoking during pregnancy from an average of 23% in 1998 to an average of 15% by 2010.Targets vary in other parts of the United Kingdom but at a local level additional requirements have been placed on the health care system (particularly primary care trusts in England) to reduce the proportion of mothers smoking at the time of delivery (data collected through hospital maternity records) by 1% each year for three years up to 2010 (O'Gorman, 2008).These targets reflect government awareness of the adverse effects of smoking during pregnancy that Smoking During Pregnancy and Smoking Cessation Services Linda BauldUniversity of Bath, United Kingdom T he 2008 UK National Smoking Cessation Conference (UKNSSC) included a number of oral and poster presentations on the theme of smoking during pregnancy. This is a challenging area of research and practice and one in which new evidence -both about the effects of smoking in pregnancy and about smoking cessation interventions -is regularly emerging. Papers at UKNSCC explored why few women access support to stop (Felix Naughton), how best to refer women to specialist services (Joan Braithwaite), social marketing approaches (Deborah Richardson and Wendy Dudley) and physical activity for...

Financial incentives for smoking cessation in pregnancy: a single‐arm intervention study assessing cessation and gaming

“…A recent Cochrane Review found financial incentive schemes to be the single most effective intervention for smoking cessation in pregnancy, with an estimated quit rate of 24% for those offered incentives compared with 6% for those receiving other interventions [ 5 ]. The promising use of financial incentives for promoting smoking cessation and improving birth outcomes has also been confirmed by a recent analytical review focusing specifically on this intervention [ 6 ], as well as by a meta-analysis of the three most robust trials in the Cochrane review [ 7 ]. These trials, however [ 8 – 10 ], included only 350 women in total and used only 7-day point prevalence of smoking abstinence as a primary outcome, leading authors to recommend replication in more robust designs, using larger samples and standardized assessments of continuous abstinence.…”

Qualitative systematic review: barriers and facilitators to smoking cessation experienced by women in pregnancy and following childbirth

“…The majority of adults, including pregnant women, are aware that smoking in pregnancy compromises the health of the baby (HEA , Arnold et al . ) and a wide range of information and support is available to pregnant women to help them quit (Bauld ). However, the majority of pregnant smokers do not quit.…”

The effectiveness of financial incentives for smoking cessation during pregnancy: is it from being paid or from the extra aid?

“…A recently updated systematic review [9] found the most effective of these to involve the use of financial incentives for stopping smoking (financial incentives vs. other interventions: OR 0.73, 95% CI 0.66 to 0.82). Findings were based on results from four trials conducted in the USA [10-13] and were confirmed by a further meta-analysis of three of these [14]. The mechanisms by which financial incentives operate to influence behaviour, including smoking cessation during pregnancy, are, however, poorly understood.…”