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Pregnant Women's Experiences and Views on an "Opt-Out" Referral Pathway to Specialist Smoking Cessation Support: A Qualitative Evaluation.

Accepted version
Peer-reviewed

Repository DOI


Type

Article

Change log

Authors

Sloan, Melanie 
Campbell, Katarzyna A 
Bowker, Katharine 
Coleman, Tim 
Cooper, Sue 

Abstract

INTRODUCTION: Smoking in pregnancy remains an important and costly public health concern with policy makers worldwide researching methods to aid cessation. UK government guidelines recommend implementation of an "opt-out" (ie, whether requested or not) referral pathway for pregnant smokers to specialist smoking cessation support using carbon monoxide (CO) screening. This study explores the views of pregnant smokers who experienced this new pathway in one UK hospital trust. METHODS: Eighteen semi-structured telephone interviews with women who experienced the opt-out pathway were undertaken. Data were analyzed thematically. RESULTS: Three themes were identified relating to expectations, acceptability and impact of the pathway. Women were generally very accepting of the CO testing especially when it met their prior expectations and was perceived as being a routine component of antenatal care. They considered the visual feedback from the CO monitoring improved their motivation to quit. Views on the automatic referral for cessation support were divided with questions raised as to the removal of choice, with many women also expressing dissatisfaction about perceived lack of contact by Stop Smoking Services (SSS) following referral. CONCLUSION: The opt-out pathway is potentially an acceptable addition to current practice. The women considered CO monitoring to be the most valuable element of the pathway. Women keen to engage with SSS desired a more efficient system of contact. IMPLICATIONS: This study presents a unique insight into pregnant women's views on the implementation of opt-out referrals for smoking cessation. Introducing CO testing and opt-out referrals at the time of antenatal ultrasound examination can potentially increase motivation to stop smoking in pregnancy. The findings demonstrate that facilitating access to SSS was not always achieved, and further refinement is needed to ensure more effective contact procedures. Ensuring all women are fully informed prior to the CO testing may further improve both the impact of the opt-out referral pathway and the chance of successfully engaging with SSS.

Description

Keywords

Adult, Female, Health Knowledge, Attitudes, Practice, Humans, Pregnancy, Pregnancy Complications, Referral and Consultation, Smoking, Smoking Cessation, United Kingdom

Journal Title

Nicotine Tob Res

Conference Name

Journal ISSN

1462-2203
1469-994X

Volume Title

18

Publisher

Oxford University Press (OUP)
Sponsorship
This article presents independent research funded by the National Institute for Health Research (NIHR) under the Programme Grants for Applied Research programme (RP-PG-0109-10020). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.