Rationale

In NSW, smoking rates amongst females are highest in women of child bearing age with the Hunter New England experiencing significantly higher maternal smoking rates compared to NSW (22.4% vs 14.7%). After birth, almost half of all new born Hunter New England infants are exposed to environmental tobacco smoke (ETS), again, predominantly due to their mother’s smoking. Smoking during and after pregnancy increases the risk of both mother and child experiencing negative health consequences including; premature birth, low birth weight, sudden infant death syndrome, respiratory illnesses, asthma, cancer and cardiovascular disease. Many mothers who stop smoking during pregnancy are likely to relapse, and hence have an increased risk of a large number of chronic and other diseases later in life.

Pregnancy offers an ideal opportunity to intervene with a large proportion of the smoking population for a number of reasons. Firstly, during pregnancy women are more amenable to health related advice. Secondly, during the childbirth continuum women will have multiple contacts with health services.

Aims and objectives

The overall aim of the project is to reduce the prevalence of smoking during pregnancy amongst Hunter women attending Hunter New England Health antenatal facilities.

The specific objectives are to:

• Increase best practice screening amongst women attending Hunter New England Health antenatal facilities.
• Increase the provision of best practice smoking cessation care to women attending Hunter New England Health antenatal facilities.

Overview of service

In collaboration with antenatal services throughout Hunter New England Health, best practice screening and care protocols for the prevention of tobacco related harm will be developed and implemented. This will involve asking all pregnant women questions about their smoking and providing care such as referral to the NSW Quitline, brief cessation counselling and printed resources to all identified smokers. To support the implementation of these enhancements to service delivery, an organisational change model will be applied which will focus on system and procedure enhancements, such as changes to existing databases and forms, facilitating senior leadership and management support, quality control including performance feedback, staff training and effective communication.