This project aimed to evaluate the effectiveness of the Smokefree Homes Service in Stoke on Trent to see if it was an effective way to reduce children's exposure to environmental tobacco smoke and make homes smoke free.
September 2016 - April 2018
Natural experimental evaluation of a complex intervention to promote increased smoking cessation rates among pregnant women in maternity care
Research Team: Professor Ruth Bell, Dr Sharon Hamilton, Professor Luke Vale, Dr Vera Araujo-Soares and Professor Steven Rushton
Who's involved: Fuse
April 2013 - July 2015
The number of women who smoke during pregnancy is higher in the North East than elsewhere in England.
Smoking during pregnancy has a significant impact on women’s and babies’ health, including increased risk of premature births, stillbirths, miscarriages, low birthweight and complications after labour.
The NIHR School for Public Health Research funded research led by Fuse: The Centre for Translational Research in Public Health, to evaluate the babyClear© programme.
The programme follows the National Institute for Health and Care Excellence (NICE) guidance on smoking and pregnancy by screening all pregnant women for smoking using carbon monoxide monitoring.
In 2013, babyClear© was rolled out in maternity units across all eight of the Foundation Trusts in the North East of England. At their first appointment, women were offered carbon monoxide (CO) monitoring, if they had a high carbon monoxide reading they were referred to Stop Smoking Services within 24 hours and received extra help and follow up support from a trained smoking cessation advisor.
The evaluation examined the effectiveness of babyClear©, looking both at numbers of women quitting smoking before delivery, but also at the impact on health indicators such as low birth weight. The evaluation looked at how acceptable the intervention was with participating women smokers and explored the service conditions to ensure the long term delivery of babyClear©.
Researchers examined the records of 37,726 births of single babies across the North East, including 10,594 to mothers who smoked during pregnancy. The evaluation found that within the first three months of rolling out babyClear© the referral rate to Stop Smoking Services more than doubled (2.5 times higher) across all the Trusts in the region.
The findings revealed the number of pregnant women to quit smoking almost doubled and was associated with increased referrals to stop smoking services.
The evaluation also found women who quit smoking were more likely to have heavier and healthier babies.
The number of women smoking throughout pregnancy in the region continues to fall. In 2009/2010 22.2% of women smoked during pregnancy and by 2016 this had fallen by nearly a third, to 16%.
The evaluation showed babyClear© to be an effective way to successfully help mums-to-be quit smoking, although structural changes had to be made to organisations to accommodate the programme. BabyClear© has since been adopted by other parts of the country to help improve the health of mums-to-be and their babies.
SPHR final report: babyClear© smoking cessation during pregnancy
Bell R, Glinianaia SV, Waal ZV, Close A, Moloney E, Jones S, Araújo-Soares V, Hamilton S, Milne EM, Shucksmith J, Vale L, Willmore M, White M, Rushton S. Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: interrupted time series analysis with economic evaluation. Tobacco Control. Feb (2017).
This collaborative research was undertaken as part of the SPHR Public Health Practice Evaluation Scheme (PHPES):
SPHR project poster: Evaluation of complex intervention babyClear
SPHR Public Health Evidence Briefing: Reducing smoking in pregnancy
SPHR research briefing: babyClear effectiveness evaluation
SPHR research briefing: babyClear process evaluation