Warwickshire                                                     Stop Smoking in Pregnancy Service   Bulletin                                                No. 1, January 2007

Happy New Year!!

Welcome to a new quarterly bulletin with updates, information and new research on smoking and pregnancy issue.  We hope you will find this useful and if there is anything you would like to see in future issues please do let us know via the contacts overleaf.

As we enter 2007 there really hasn’t been a better time for smokers to quit, with more services available to help them and the forthcoming smoke free law prompting many smokers to go smoke free.  For more information about the whole range of stop smoking services available contact us on 0800 0852917.

Don’t forget to raise the issue of smoking with all clients and ask if they would like a referral to one of the Specialist Stop Smoking in Pregnancy Advisors.  A copy of the referral form is attached.  You or the client can also phone an Advisor direct – see overleaf for contact details.

 When a client is referred to the Stop Smoking in Pregnancy Service the following will take place:

1. The Advisor will contact the client to arrange an appointment (if no contact by phone can be made a letter will be sent out inviting the client to contact the Advisor if they wish to)
2. The Advisor will visit the client usually at home to plan a strategy for quitting and prescribe nicotine replacement therapy where appropriate.  Other family members can be included.
3. The Advisor will make regular visits and contact the client by phone over the first few weeks of quitting to provide support and monitor progress.  Additional supplies of nicotine replacement therapy will be prescribed where the quit attempt is continuing.

 Pregnant smokers can also be seen in GP surgeries and selected Pharmacies.

 The document was written in October 2003.  Following the Medicines and Healthcare Authority Agency (MHRA) - Report of the Committee of Safety of Medicines Working Group on Nicotine Replacement Therapy which recommended the widening of access to nicotine replacement therapy we are updating the Warwickshire protocol.  If you would like a copy please contact us on 0800 0852917.

 Summary of service delivery for April-September 2006.

Area	No. Setting Quit Date	% Quit at 4 Weeks
Warwickshire	106	29
North Warks	31	29
Rugby	29	17
South Warks	46	37

Note: A small proportion of these women were seen in GP surgeries/pharmacies.

 We can provide tailor-made training for groups and also have a regular training programme.  If you would like training please contact Jane Wright, Smoking Cessation Manager, to discuss further on 0800 08523917.

 These have recently been circulated to all Stop Smoking Services in the West Midlands.  The Stop Smoking in Pregnancy Service Steering is currently looking at these draft recommendations to start to benchmark the Warwickshire service against. 

 The regional Smoking and Pregnancy group and the Peri-natal Institute is currently working on an NRT registry to provide sound information about the use of NRT in pregnancy.  Warwickshire is currently piloting the data collection method.

 Best Practice in smoking cessation services for pregnant women: results of a survey of three services reporting the highest national returns, and three beacon services, Journal of the Royal Society for the Promotion of Health, Vol. 126, No5, 233-238

This showed that the key elements of the successful services were systematic training of midwives in how to refer pregnant smokers, offering nicotine replacement therapy to almost all clients and having an efficient system of providing the prescriptions, offering flexible home visits, and providing intensive multi-session treatment delivered by a small number of dedicated staff.

 Smoking status in the initial weeks of quitting as a predictor of smoking cessation outcomes in pregnant women, Drug and Alcohol Dependence, Vol 85, Issue 2, 8 November 2006, pg 138-141.

Any smoking in the initial 2 weeks of a quit attempt predicts poor short- and long-term outcomes in the general population of cigarette smokers.  Data was obtained from women participating in clinical trials on smoking cessation examining the efficacy of voucher-based incentives delivered contingent on biochemically-verified abstinence or a control condition wherein incentives were given independent of smoking status.  Smoking status was assessed in weeks 1 and 2 of the quit attempt and again at an end of pregnancy assessment scheduled at weeks 28-32 gestation using self-report and biochemical verification.  Smoking in weeks 1 and 2 predicted smoking at the end of pregnancy assessment independent of treatment condition.  There was 79% and 92% chance that those who smoked in weeks 1 and 2 would be classified as smokers at end of pregnancy assessment in the contingent-incentive and control conditions, respectively.

The smoke free law comes into force from 1 July 2007 when all enclosed public places will become smoke free.  The regulations are due out shortly – see www.smokefreeengland.co.uk for more information.

The national Tobacco Control Programme has a new identity – SMOKEFREE.

This, and variations, will now be on all new materials from the Dept of Health.

Look out for the new websites for tobacco issues:

For smokers - www.gosmokefree.co.uk (replaces www.givingupsmoking.co.uk)

For workplaces – www.smokefreeengland.co.uk

The Smoke Free Warwickshire website has been updated and can be found at www.smokefreewarwickshire.org.

With the new smokefree logo and the smokefree law from 1 July the Dept of Health is revising its publications.  We will send out a new order form when we get a list of what will be available. 

No Smoking Day is on 14 March this year and the theme is “Make a Fresh Start”.    With the smoke free law coming in it is likely that more smokers than ever will use No Smoking Day as an opportunity to give up for good.  Events and activities are currently being planned by the Warwickshire No Smoking Group and resources will be heading your way, but in the meantime go to www.nosmokingday.org for more information. 

 As from 1 January 2007 Warwickshire PCT will be completely smoke free in all its buildings.  This will protect staff, patients and visitors from the harmful effects of second hand smoke. 

Contacts for Specialist Stop Smoking in Pregnancy Advisors Rural North    Jackie Jones   07833 945221 N&B                Sue Barlow     07920 507305 Rugby             Betty Ritchie    07793 661738 South Warks  Sue Randall    07702593359 ______________________________________ Bulletin produced by: Warwickshire Stop Smoking Service Smokefree Warwickshire FREEPOST MID23827 Leamington Spa CV32 5BR  Tel: 0800 0852917