Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/18742
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Implementation of routine biochemical validation and an 'opt out' referral pathway for smoking cessation in pregnancy
Authors: Bauld, Linda
Hackshaw, Lucy
Ferguson, Janet
Coleman, Tim
Taylor, Gordon
Salway, Ruth
Contact Email: linda.bauld@stir.ac.uk
Keywords: Carbon monoxide
cotinine
pilot
pregnancy
referral
smoking cessation
Issue Date: Dec-2012
Publisher: Wiley-Blackwell
Citation: Bauld L, Hackshaw L, Ferguson J, Coleman T, Taylor G & Salway R (2012) Implementation of routine biochemical validation and an 'opt out' referral pathway for smoking cessation in pregnancy, Addiction, 107 (Supplement 2), pp. 53-60.
Abstract: Aims: To introduce an ‘opt out' referral pathway for smoking cessation in pregnancy and to compare different methods for identifying pregnant smokers in maternity care. Design: Pilot study that analysed routine data from maternity and smoking cessation services with biochemical validation of smoking status. Setting: Dudley and South Birmingham, England. Participants: A total of 3712 women who entered the referral pathway-1498 in Dudley and 2214 in South Birmingham. Measurements: Routine monitoring data on smoking at maternity booking, referral to smoking cessation services, number of women who set quit dates set and short-term (4-week) self-report smoking status. Comparison of self-report, carbon monoxide (CO)-validated and urinary cotinine-validated smoking status for a subsample (n = 1492) of women at maternity booking. Findings: In Dudley 27% of women who entered the opt out referral pathway were identified as smokers following CO testing. Of those referred to the smoking cessation services, 19% reported stopping smoking at 4-week follow-up. In South Birmingham 17% were smokers at booking, with 5% of those referred recorded as non-smokers at 4 weeks. The number of women quitting did not increase during the study when compared with the previous year, despite higher referral rates in both areas. An optimum cut-off CO measurement of 4 parts per million (p.p.m.) was identified for sensitivity and specificity. Conclusion: The introduction of an opt out referral pathway between maternity and stop smoking services resulted in more women being referred for support to quit but not higher numbers of quitters, suggesting that automatic referral may include women who are not motivated to stop and who may not engage with services. Routine carbon monoxide monitoring introduced as part of a referral pathway should involve a cut-off of 4 p.p.m. to identify smoking in pregnancy.
Type: Journal Article
URI: http://hdl.handle.net/1893/18742
DOI Link: http://dx.doi.org/10.1111/j.1360-0443.2012.04086.x
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: Institute for Social Marketing
University of Nottingham
Socio-Management
University of Nottingham
University of Bath
University of Bath

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