Complex systems

babyClear© - promoting smoking cessation in pregnant women

The proportion of women smoking 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 and low birthweight.

Fuse researchers from Newcastle University and Teesside University worked in partnership with Fresh (the regional North East tobacco control programme), midwives and stop smoking staff and identified a need for improved implementation of National Institute for Health and Care Excellence guidance to support pregnant women to quit smoking.

This work led to the implementation of babyClear©, a system-wide service reconfiguration. Routine carbon monoxide monitoring and opt-out referral to Stop Smoking Services were introduced across all eight NHS Trusts in the region, underpinned by training of front line staff in maternity and smoking cessation services, and the introduction of a clear referral pathway.

Fuse evaluated the effectiveness and process of implementation of this initiative with funding from the NIHR School for Public Health Research (SPHR) Public Health Practice Evaluation Scheme (PHPES). Results showed that quit rates in pregnancy nearly doubled, and there was a significant increase in birthweight among quitters’ babies. For maximum benefit, organisations needed the ability to reorganise and standardise their systems, requiring belief from staff, maintenance of practical adjustments.


Last modified: Fri, 15 Feb 2019 12:27:58 GMT