Women who receive specialist support from health visitors after giving birth may be more likely to remain smoke-free after quitting during pregnancy, according to a new University of East Anglia-led study published in the BMJ.
The “may be more likely” wording is deliberate because the strongest result comes from participants who received the intervention as intended, not the entire randomized group.
The researchers tested Baby Breathe, a smoking-relapse prevention programme designed for women who quit smoking before or during pregnancy. The programme combines one-to-one support from trained health visitors with digital resources, text-message support, a website and app, and a relapse-prevention kit provided after childbirth.
The study included 886 women in England and Scotland who had successfully stopped smoking before or during pregnancy. Participants were randomly assigned to receive either the Baby Breathe intervention or usual care.
However, the intervention was not delivered as intended to around one in five participants, partly because of health visitor workforce pressures, missed appointments and administrative issues.
Among women who received the intervention as intended, 57.6% remained smoke-free 12 months after giving birth, compared with 49.9% of women receiving usual care.
The findings suggest that trained health visitors could play an important role in helping women maintain smoking cessation during the postpartum period, when the risk of returning to smoking may increase.
Quitting smoking during pregnancy is an incredible achievement, but staying smoke-free after a baby is born can be just as challenging. Too often, support ends once a woman has quit, even though the stressful months after birth are when many women are most at risk of returning to smoking.Lead researcher Prof Caitlin Notley, Professor of Addiction Sciences at UEA’s Norwich Medical School
Our research shows that when health visiting services are trained and supported to deliver specialist relapse prevention advice, they can make a real difference by significantly improving women's chances of staying smoke-free. That means better health for mothers, babies and entire families.
Maintaining smoking cessation after childbirth can benefit both mothers and children by reducing exposure to second-hand smoke and lowering the risk of smoking-related disease. Researchers also noted that parents remaining smoke-free may help reduce the likelihood of children taking up smoking later in life.
The researchers noted that incomplete delivery of the intervention and low engagement with some programmed components affected the study’s primary analysis. They also cautioned that participants were generally more highly educated and less socioeconomically deprived than the wider population, which may limit how widely the findings can be applied.
The researchers said the findings support greater training for health visitors in smoking-relapse prevention and suggest that postpartum support could extend the smoking-cessation care women receive during pregnancy.
Effectiveness of the Baby Breathe intervention for maintaining postpartum smoking cessation: Multi-Centre pragmatic randomized controlled trial’ is published in the BMJ.
(Newswise/AM)