Smoking cessation during pregnancy Preconception Pregnancy NICE Guidance

Smoking cessation during pregnancy Pre-conception Pregnancy NICE Guidance PH 26 Recommendations: • Maternity service: identify and refer pregnant women who smoke to NHS Stop Smoking Services. • Stop smoking service: contact pregnant women who smoke and provide them with help to quit. How well is this implemented in Wales? The pathfinder identified some clear areas to address: • Need to establish consistent data recording and collection • Improve referral systems and processes • CO monitoring is not used in all health boards • Need to review the model for smoking cessation delivery to pregnant smokers 0 – 5 years Benefits of increasing % of women going to Stop Smoking Wales Savings by increasing uptake from 11% to 25% in Wales per year Cases due to smoking Total cost £ Total maternal complications 141. 01 362, 249 Total infant complications 92. 89 80, 814 Total savings 233. 9 443, 064 1. Assumes current uptake is 11% - no data to verify this in Wales 2. Does not take into account costs NICE Costing template PH 26 What’s next? • Pilot work is due to begin shortly in four health boards to evaluate various models for delivery of smoking cessation service to pregnant women. Effectiveness of interventions: small effects Outcome Birth Absolute risk reduction NNT Smoking late pregnancy 1. 9% 53 Low birth weight 1. 7% 60 Preterm birth 1. 0% 100 Lumley et al Cochrane Database of Systematic Reviews 2009. • A modelling project will estimate the wider public health impacts of smoking cessation during pregnancy. The model will allow us to explore the effect of smoking on birth outcomes and predict where an increase in uptake of smoking cessation services would have the most effect. • New approaches are required. We need to look at the potential for using financial incentives, pharmacist interventions, interventions at preconception stage and better targeting of services.