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Smoking in Pregnancy Project Report: June 2012<br />

Tick all<br />

that apply<br />

Comments<br />

Supplementary questions<br />

Please indicate the number of maternity<br />

acute trusts in your PCT<br />

Please provide the number of smoking in<br />

pregnancy referrals received by your LSSS<br />

2010/11<br />

How does your LSSS currently receive<br />

smoking in pregnancy referrals?<br />

Do you receive any of your smoking in<br />

pregnancy referrals via an electronic<br />

referral system?<br />

Protocols / guidelines<br />

Do you have any agreed protocols /<br />

guidelines or procedures in place with<br />

your maternity services linked to the<br />

identification and referral of pregnant<br />

smokers?<br />

If yes, please state<br />

Training<br />

What % of midwives has been recently<br />

trained to deliver smoking cessation very<br />

brief advice?<br />

Have you recently trained any other health<br />

professionals to deliver smoking cessation<br />

very brief advice?<br />

If yes, please indicate which HCP<br />

What % of midwives has been trained<br />

to use CO monitors to identify pregnant<br />

smokers?<br />

Have you trained any other health<br />

professionals to use CO monitors to<br />

identify pregnant smokers?<br />

If yes, please indicate which HCP<br />

50

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