Parents-to-be in Somerset are now less likely to smoke, thanks to a successful local campaign. Over the last five years Mums2Be Smokefree has helped nearly 1,700 to quit tobacco. As a result, babies in the county are less likely to be admitted to a Neonatal Intensive Care Unit (NICU) due to smoking in pregnancy. Free long term support, medication, home visits and telephone contact were found to help support and motivate people to stop smoking.
The service has five Stop Smoking Practitioners who work across Somerset to support expectant parents to give up smoking. Currently 78% of those who used the service have quit at 12 weeks and of those 82% were non-smoking at their baby’s birth. This has helped reduce the number of NICU admissions.
Emma Vokes from Somerset didn’t realise she was pregnant and continued smoking, but then experienced a miscarriage which prompted her to make the change. Emma is full of praise for the service. She said: “I had not long restarted smoking so I did decide to quit as I wanted a family, miscarrying if anything showed me that I did want that life so I did want to quit so I could protect my baby.
“Steph, my coach, was always very understanding and would explain everything to me, such as any medications that were available. She didn’t make me feel pressured at all, but was very comforting. To other mums in my position I would say definitely get the help, don’t be afraid, it’s not worth any risk. It’s not an easy journey but once you get in the journey it gets much easier and you’ve just got to stay strong for your baby - just reach out.”
In 2020/21, 10% of people who had babies in Somerset were smoking at their time of delivery, down from 12% in 2019/20. It’s estimated that it cost £374 per person to run the Smokefree service in that period - in practitioner time, medication and vouchers. This compares to the cost of a NICU stay or long term medical care which can run into thousands of pounds.
Tracey Hellyar, Team Leader for Mums2Be Smokefree, said: “We use a combination of incentives such as shopping vouchers, medication and one to one support to assist people to give up smoking. Smoking is the most modifiable risk factor in pregnancy and I always see it as two fold. We are not just supporting somebody to quit, we are supporting the whole family unit to be smoke free. So when we see the family at that final postnatal visit, with their baby in their arms, you feel proud to have been part of their smoke free journey.”
Nationally the relative risk of admission to a NICU for babies of smoking parents is increased by at least 20% compared to those who do not smoke. And babies born to parents who smoke are likely to stay longer in a NICU. Smokers are less likely to breast/chestfeed, which is closely linked to health inequalities. This is also reflected in the Somerset data.
Stephanie Dummackin, Mums2Be Stop Smoking Practitioner, said: “Our success rate is high and we are really doing what we set out to do. There are risks through pregnancy, labour and once baby is born, so stopping at any point is beneficial. For people who smoke, there is an increased risk of intervention in labour and birth, including induction because the baby is small, and an increased risk of infection post birth.
“As well as miscarriage and stillbirth, smoking increases that risk that baby can actually die. It's quite blunt and harsh to say this, but that’s the reality of the risk. We are making people aware that quitting is the best decision. Out of anything that you can do in your pregnancy this is the biggest choice you can make to limit the long list of smoking-related risks.”
Notes for editors
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In 2020/21 10% of people who had babies in Somerset were smoking at their time of delivery (SATOD), down from 12% in 2019/20. 18% of stillborn babies were to parents who were SATOD and 17% of neonatal deaths. 18% of premature babies were born to parents who were SATOD and 20% of small for gestational age babies were born to parents who were SATOD.
Background resources:
Evidence has shown that behavioural support is effective in increasing quit rates. A Cochrane review found that compared with usual care, a combination of behavioural interventions as an adjunct to nicotine replacement therapy increased the chance of success by about 10% to 20%.The use of financial incentives for smoking cessation found that women receiving incentives were more than twice as likely to quit and remain quit postpartum compared to women receiving usual care without incentives:
Smoking during pregnancy is the leading modifiable risk factor for poor birth outcomes, including stillbirth, miscarriage, and pre-term birth. It also increases the risk of children developing several respiratory conditions, attention and hyperactivity difficulties, learning difficulties, problems of the ear, nose and throat, obesity and diabetes:
The relative risk of admission to a NICU for infants of women who smoke is increased by at least 20% compared to infants of non-smoking mothers and infants born to parents who smoke are likely to need a longer NICU stay:
National statistics for SAOTD: