Smoking at the Time of Delivery (SATOD) rates have fallen by around a quarter in the past four years – down from 1 in 8 (12.6%) new mothers in 2017-18 to fewer than 1 in 10 (9.8%) in 2020-21, meaning 945 more babies were born smokefree.
It shows the success of the Greater Manchester Health and Social Care Partnerships’ Smokefree Pregnancy programme which was set up in 2018 and is recognised as best practice nationally. In the 12 months between April 2020 and March 2021, the programme supported more than 1,700 people on their journey to stop smoking, including pregnant women and their partners, and saw a 65% successful quit rate.
The programme was created as part of efforts to give every baby the best start to life. NHS maternity staff in Greater Manchester are given comprehensive training to have open and honest conversations about the risks of smoking, use carbon monoxide (CO) screening to check for exposure to tobacco smoke and refer people who need help to a maternity-led stop smoking service.
Smoking during pregnancy or inhaling second-hand smoke from others (known as passive smoking), can raise levels of carbon monoxide (CO) within the body. This poisonous gas can restrict the essential oxygen supply to the baby and significantly increase the risk of complications such as miscarriage, premature birth, low birth weight and stillbirth.
During the pandemic, the number of women referring themselves to the stop smoking service increased, and personal carbon monoxide monitors were issued, allowing service users to complete CO screenings at home that linked through to a smartphone app which the specialist midwives could track to validate their quit journey.
Specialist midwife Andi Robertson from Rochdale Infirmary, part of Northern Care Alliance, said:
“While it’s true that some smokers are able to stop as soon as they find out they are pregnant, for lots of people it’s just not that easy. Not every pregnancy is planned, and smoking is a serious addiction which many get hooked on when they are just teenagers.
“The increased hormones and metabolic changes during pregnancy often make cravings even more intense. We know that parents-to-be are more likely to quit if they get the right support, without the worry of being judged. That’s why a stop smoking service ran by experts in pregnancy and stopping smoking is so important.”
The service offers one-to-one support and free nicotine replacement that is safe to use during pregnancy and beyond. Service users that meet eligibility criteria are also incentivised to stay smokefree with vouchers to help them prepare for the arrival of their new baby.
As highlighted by NICE and PHE’s recently published draft guidelines to tackle the health burden of smoking, incentives are both an effective and cost-effective way to support pregnant people to quit smoking.
Tierney-Rose, 21, from Rochdale, was supported by the maternity-led stop smoking service and is now enjoying a smokefree life with one-year-old daughter Maddie. She started smoking when she was just a teenager and tried to quit many times before quitting for good when she became pregnant with her first baby in spring 2019.
Tierney-Rose, who is now expecting her second baby, said: “I had smoked for almost six years and knew I would need help to quit. So, when I was asked if I smoked at my first midwife appointment, I was honest and said yes. I told the midwife that I desperately wanted to quit, and I was relieved to find that I would receive stop smoking support as part of my prenatal journey at Rochdale Infirmary.
“I wanted to do everything I could to ensure that my baby was safe and well. I researched how to give her the best start in life and had read that when you smoke a cigarette, the poisons from the smoke are passed on to your baby. I didn’t want that for her.
“I was referred to the stop smoking service and my Maternity Support Worker, Jo, was so supportive and took the time to listen to everything that was going on in my life at the time. We developed a really strong relationship, and she became a friend during that time. With Jo’s support I got through the tough times and I’ve now been smokefree for two years. Without the support I really don’t think I would have been able to quit.”
A qualified midwife for 20 years, Jane Coyne, Strategic Lead for the Greater Manchester Smokefree Pregnancy programme, has seen first-hand the devastating impact smoking can have on babies.
Jane said: “Greater Manchester has seen the number of women smoking at the time of delivery fall to its lowest level. Over the last few years, that’s almost 1,000 more babies born free from the risks of smoke that may not have been otherwise.
“Smoking is a major factor in babies being born early, unwell or in the worst cases stillborn. Unfortunately, the risks don’t end after birth – babies in homes where someone smokes are more likely to die from cot death or sudden infant death syndrome.
“Every parent wants the best for their child, but quitting smoking is not easy, and it is a serious addiction, not a lifestyle choice. That’s why the Smokefree Pregnancy programme is so important in making sure everyone gets the individual help and support they need.
“The programme is saving babies’ lives and it shows the vital role that health professionals play. I’m incredibly proud of what the team has achieved over the last three years – we must keep going with this vital work and deliver a smokefree start for every baby.”
The Greater Manchester Smokefree Pregnancy programme is an important part of the city region’s ambitious population health plan, supported by powers gained through devolution, to improve health and reduce inequalities for the area’s 2.8 million residents.
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