Housing evidence / case study · working draft
babyClear: joining up maternity smoking support
Maternity and stop-smoking services introduced a shared pathway for identifying smoking and following up referrals.
01 / THE APPROACH
What was tried
babyClear brought eight NHS trusts and local cessation services together around a consistent maternity pathway. Midwives used carbon-monoxide monitoring at booking, with opt-out referrals, staff training and agreed follow-up arrangements.
A service-user reference panel of women who had smoked during pregnancy helped the process evaluation develop research materials and interpret findings. This involvement concerned the evaluation, rather than demonstrating that women co-designed every programme component.
02 / THE FINDINGS
What was learned
The effectiveness study analysed 37,726 singleton deliveries, including 10,594 pregnancies classified as smoking. Referrals increased more than twofold after implementation, and the adjusted odds of quitting by delivery were 1.81 times those beforehand.
03 / TRANSFER TO WALES
What Wales could learn
Midwives and cessation teams needed a shared referral process, carbon-monoxide monitors, staff training and agreed follow-up. Women with experience of smoking in pregnancy contributed to the evaluation.
The practical example is joining existing teams into a consistent pathway, with results measured at delivery rather than assuming an early referral means someone has quit.
Sources & review
Bell et al., Tobacco Control 27, 90–98, DOI 10.1136/tobaccocontrol-2016-053476 (online 2017, issue 2018). NIHR process-evaluation briefing. Primary effectiveness study checked 23 October 2026; patient involvement is described in the process-evaluation research supplied with the dossier.
