PMM.58 Who should support pregnant women to quit smoking? Early findings from a quasi-experiment building upon NICE guidance: Models for Access to Maternal Smoking cessation Support (MAMSS)

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Abstract

Background

Maternal smoking is a key cause of poor outcomes for mothers, babies and children (1). Within the UK 26% of mothers smoke before or during pregnancy and 12% smoke throughout their pregnancy (2). Despite various improvements within the NHS Stop Smoking Service to strengthen the intervention for pregnant women, referrals and successful quit attempts for this group have continued to remain extremely low. A key element of UK national guidance for smoking cessation during pregnancy is to provide a flexible and tailored service to help increase levels of engagement (3). However, the guidance does not recommend who should deliver flexible, tailored smoking cessation support to pregnant women.

Research

Design

Research

Our study is adopting a quasi-experimental design over a 12 month period, to test the effectiveness of three different models of service implementation; delivery by midwife, midwifery support worker and maternity stop smoking specialist. Core recommendations from NICE guidance are being implemented across intervention and usual care sites. Support in intervention sites is being delivered more flexibly than in usual care sites, including home visits and telephone support. Effectiveness and cost effectiveness are assessed alongside a process evaluation.

Findings

Interim results, based on the first six months data, will be presented. Outcome measures include: engagement with stop smoking support, pregnant smokers who set a quit date, pregnant smokers who quit at four weeks (carbon monoxide verified), smoking status during third trimester and birth outcomes (low birth weight (<2500 g), preterm birth <37 weeks). Barriers and facilitators to implementation will also be discussed.

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