published

Smoking in Pregnancy Project Report: June 2012
Lastly, the challenges experienced through these projects, in particular those experienced
in Central & Eastern Cheshire, do provide valuable learning points for other local areas
looking to implement similar systems. Firstly, it is very important that relevant IG colleagues
are engaged from the outset and that key terminology is commonly defined by all those
involved. The disparity in the interpretation of ‘opt-out’ for example unfortunately led to
considerable delays in this pilot. In terms of project management, this highlighted the need
for aims and objectives to be unambiguously relayed to everyone included in leading the
pilot or project from the beginning. The variance in opt-out definition is also of significance
in a wider sense and should be considered in any future testing or evaluation of such
approaches. It was also evident across the project that, in line with the findings from the
UKCTCS smoking in pregnancy project, considerable time is required before changes in
practice are adopted and often such change will have to compete against conflicting priorities.
In addition a real need for ownership at a local level in order for implementation to succeed
was apparent.
In conclusion, the short smoking in pregnancy pilots conducted by the NCSCT have resulted
in the development of a web based electronic referral system for use with pregnant smokers
and /or their partners as well as family members, and has shown that such a system can
work in practice. Local areas looking to implement systems are encouraged to take into
account the learning from the projects as they do so. It is suggested that a longer-term pilot
for a minimum of 12 months would allow a full evaluation of the use of the NPRS throughout
the pregnancy pathway and could be used to assess smoking status and CO monitoring at
booking and, in particular, at time of delivery in more detail.
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