published

Smoking in Pregnancy Project Report: June 2012
Telephone interviews were conducted with six HCPs in January 2012.* Interviews explored
the HCPs’ involvement and role within the set up and implementation of the pilot, their
views on identifying pregnant smokers in a healthcare setting, their experiences of and
opinions about the web based referral system, their understanding of opt out referral
processes and discussion about rolling out the pilot nationally.
The six interviewees were all HCPs based within Central and Eastern Cheshire PCT, staff
were based in the community, within the hospital or within the local stop smoking service.
The HCPs covered a range of roles, all of whom had some form of involvement with pregnant
smokers. Some of the HCPs had direct contact with the pregnant smokers, others were in
managerial positions. Some of the interviewees had been involved with the implementation
of the pilot from the beginning; some had come on board during the planning process,
whereas others only became aware of the pilot when they learnt of its implementation in
relation to changes to their daily practice.
As previously stated, it was initially intended that the pilot would be implemented across
two hospitals, Leighton Hospital and Macclesfield District General Hospital, which are both
supported by Cheshire East Stop Smoking Service, however Leighton Hospital withdrew
their involvement from the pilot imminently prior to implementation. One interviewee was
based at Leighton Hospital, the others were based at Macclesfield District General Hospital
(3), based out in community (1) or worked for Cheshire East Stop Smoking Service (1). The
semi structured interviews lasted for between 20 to 60 minutes, were audio recorded with
permission and transcribed verbatim.
Following thematic analysis the subsequent key themes emerged.
3.1.4.1 Identifying and referring pregnant women
The foundation of the web based referral process was to improve the system of identifying
and referring pregnant smokers for support to stop smoking. However, an assumption was
made that the HCPs believed that smoking status should be identified and discussed with
pregnant women. Interviews began by initially exploring this assumption, asking whether
they agreed that it was right to ask pregnant women about their smoking status, and if so,
whether they felt that the NHS should be offering support to these women.
All interviewees agreed with the principle of asking about smoking and offering support
to stop. Some justified this with descriptions of the harm that smoking can cause to mother
and unborn child or by highlighting the benefits of cessation during pregnancy.
* Interviews had initially been intended to take place half way through the data collection period,
to explore opinions of the web-based referral pathway, examining any issues that had arisen
and highlight benefits of the new system. However due to the delay to implementation, five out
of the six interviews were carried out prior to the referral system ‘going live’ – this limited the
extent to which questions could be answered and many responses were answered prospectively.
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