Abstract
BackgroundThe UK National Health Service provides Stop Smoking Services for pregnant women (SSSP) but there is a lack of evidence concerning how these are best organised. This study investigates influences on services’ effectiveness and also on their propensity to engage pregnant smokers with support in stopping smoking.MethodsSurvey data collected from 121/141 (86%) of SSSP were augmented with data from Hospital Episode Statistics and the 2011 UK National Census. ‘Reach’ or propensity to engage smokers with support was defined as the percentage of pregnant smokers setting a quit date with SSSP support, and ‘Effectiveness’ as the percentage of women who set a quit date who also reported abstinence at four weeks later. A bivariate (i.e. two outcome variable) response Markov Chain Monte Carlo model was used to identify service-level factors associated with the Reach and Effectiveness of SSSP.ResultsBeta coefficients represent a percentage change in Reach and Effectiveness by the covariate. Providing the majority of one-to-one contacts in a clinic rather than at home increased both Reach (%) (β: 6.97, 95% CI: 3.34, 10.60) and Effectiveness (%) (β: 7.37, 95% CI: 3.03, 11.70). Reach of SSSP was also increased when the population served was more deprived (β for increase in Reach with a one unit increase in IMD score: 0.55, 95% CI: 0.25, 0.85), had a lower proportion of people with dependent children (β: -2.52, 95% CI: -3.82, −1.22), and a lower proportion of people in managerial or professional occupations (β: -0.31, 95% CI: -0.59, −0.03). The Effectiveness of SSSP was decreased in those areas that had a greater percentage of people >16 years with no educational qualifications (β: -0.51, 95% CI: -0.95, −0.07).ConclusionsTo engage pregnant smokers and to encourage them to quit, it may be more efficient for SSSP support to be focussed around clinics, rather than women’s homes. Reach of SSSP is inversely associated with disadvantage and efforts should be made to contact these women as they are less likely to achieve abstinence in the short and longer term.
Highlights
The UK National Health Service provides Stop Smoking Services for pregnant women (SSSP) but there is a lack of evidence concerning how these are best organised
[11] few countries systematically offer smoking cessation support to pregnant women, despite this being consistent with Article 14 of the Framework Convention on Tobacco Control, [13] the international public health treaty which has been adopted by World Health Organisation (WHO)
A new Deviance Information Criterion (DIC) was calculated after adding a variable to the model; if the DIC decreased by more than two points, this indicated that the model was a significantly better fit with that variable included
Summary
The UK National Health Service provides Stop Smoking Services for pregnant women (SSSP) but there is a lack of evidence concerning how these are best organised. [11] few countries systematically offer smoking cessation support to pregnant women, despite this being consistent with Article 14 of the Framework Convention on Tobacco Control, [13] the international public health treaty which has been adopted by WHO. The UK is one country which offers no-cost smoking cessation support to all pregnant women; such support is provided by local stop smoking services (SSS) which are available nationally. Stop smoking services for pregnancy (SSSP) are mature components of the UK National Health Service (NHS), there is only limited evidence to guide their provision. UK SSS for nonpregnant smokers have been evaluated such that, short [14] and longer term outcomes [15] are known and outcome variations have been investigated. [16] In the nonpregnant population, group support helped a greater number of smokers to quit at four weeks, and SSS in more deprived areas reached more people, but SSS that operated in these more disadvantaged areas had lower cessation rates than those in more affluent areas [16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
