Trailblazing project that helps pregnant smokers to quit is hailed a success

Pregnant women across North Wales are giving up smoking thanks to a ground-breaking specialist service which is delivered in their own homes.

As part of the NHS Help Me Quit for Baby project, run by the Betsi Cadwaladr University Health Board, a dedicated team of smoking cessation advisors, who work solely with pregnant smokers, see women in their own homes for as many appointments as takes for them to quit. They also offer support to family members or partners who want to quit.

Across Wales, around 16% of mums-to-be smoke throughout their pregnancy and 11,864 unborn babies are exposed to harm from tobacco each year.

The Betsi Cadwaladr University Health Board area where 5,800 babies were born between 2017-18, has one of the highest rates of pregnant smokers in Wales. Thanks to the project 238 pregnant women were given help to quit between April 2018 and March 2019, according to the Welsh Government’s latest figures on smoking cessation services.

One in five sudden infant deaths is linked to smoking, as well as long term problems in children such as learning difficulties, hyperactivity, ear, nose and throat problems, obesity and diabetes. Research has shown that children with parents that smoke are three times more likely to take up the habit in later life.

Women in North Wales are referred to the Help Me Quit for Baby service by their midwife at any time during their pregnancy, after taking a CO monitor test to measure the amount of carbon monoxide in their bodies. If a woman agrees to take part in the programme, she is offered weekly specialist support and free nicotine replacement therapy (NRT).

The team believes being able to see women in the comfort of their own home, is key to their success. Home visits also mean the team can also speak with other members of the family who smoke and offer them cessation support. As well as protecting the health of the unborn baby, the team hopes that by helping women and their families to quit smoking, they can enable the baby to live in a smoke-free home once it is born.

“A woman’s family has a huge influence on whether she continues to smoke,” said Kellie Salmon, one of the support workers.

“If a partner is adamant that they want to carry on smoking then that’s a really big barrier to the woman giving up and means you have to work even harder to get them to quit. But if the partner is on board then there’s good chance they will quit together.

 “The fact that we see women in their own homes is a unique selling point of the scheme.  It’s great from a practical point of view because a lot of them live in rural areas and some can’t drive. But it also makes it easier to establish a rapport with them because often they are more relaxed and comfortable in their own home environment.”

During the appointments the team get to know the women they work with and find out more about why they smoke, admitting they can often become ‘a shoulder to cry on’. A big part of the quit process is encouraging behavioural change and getting them to adjust their daily routine, according to Help Me Quit for Baby team member Jackie Buckley. She said:

“Many women say the only way they can cope with their lives is by smoking.  They see it as the only way they can have five minutes to themselves. So, we encourage them to find other ways to de-stress such as playing a game on their phone instead.

“Often they go round to see their families and everybody gathers together to have a smoke. It’s a ritual and they still want to be a part of that. It’s really important to get them to come up with their own ideas of how to deal with those sorts of situations.”

Smoking in pregnancy carries serious health risk. The carbon monoxide in tobacco smoke reduces the amount of oxygen to the placenta which can lead to

  • Premature delivery
  • Increased risk of miscarriage
  • Still birth
  • Sudden infant death.

There is, says Jackie, a big taboo around the subject of smoking in pregnancy, and many women feel ashamed of their habit – a feeling that stops some admitting they smoke and seeking help to quit.

The team aims to adopt a totally non-judgemental approach to the women they work with and are keen to empathise that they are not there to criticise or lecture their clients: “We take a very non-judgemental approach,” said Jackie.

 “We tell women that we’re not there to judge them but to get the best support for them to quit smoking. If it becomes too clinical then that becomes a barrier so we try to speak to them as we would with a friend and we encourage them to be honest, for instance, if there is a blip and they start smoking again. It also helps to share stories of other women we have worked with who have managed to stop smoking.”

Although women are primarily referred to Help Me Quit for Baby by their midwives, as news of the project’s success spreads, the team are increasingly being contacted by women who have heard about their work via word of mouth.

The greatest reward for the team however, is when a woman successfully quits smoking, giving her new born baby, a better chance in life: “When people do quit it’s just so rewarding and we really feel we’re doing a job that makes a difference to people’s lives,” said Kellie.

Suzanne Cass is CEO of the tobacco control campaign group ASH Wales. She congratulated the team on the success of the scheme and said she hoped it would one day be available across Wales: “Smoking is not a lifestyle choice for pregnant women, it is an addiction that poses a serious health risk to them and their babies.

“It is crucially important that tailored, non-judgmental support is available to help these women to quit in an environment that they feel comfortable in.

“The success of this project shows what can be achieved by thinking outside the box and providing flexible, innovative and targeted support that is designed to meet the needs of pregnant smokers and their families.”

 

Editor’s Notes

According to experimental statistics on maternity statistics in Wales 2017-18 published on November 1 2018, the percentage of women who smoked in pregnancy in the Betsi Cadwaladr ULHB was 20.5%.

Enquiries: Diana Milne | PR Officer] | diana@ashwales.org.uk | 02920 490621| 0781 851 8567|

Or Beth Mahoney | Marketing and Communications Manager | Beth@ashwales.org.uk | 02920 490621|

Is smoking bad for your skin?

The simple answer is yes.  You only have to look at a heavy smoker to see the damage it causes to their skin.

Smoking prematurely ages your skin by between 10 and 20 years. You’re three times more likely to develop facial wrinkles if you’re a smoker, particularly around your eyes and mouth and many smokers have a sallow yellow-grey complexion.

But why?

This is because when you smoke it reduces the amount of oxygen in your bloodstream. This means there is less oxygen reaching your skin, meaning it ages more quickly and has a dull, grey appearance.

It also reduces the levels of collagen in your skin, a protein that keeps skin elastic. Without adequate supplies of collagen, wrinkles start to develop.

The toxins in the cigarette smoke also cause cellulite, regardless or your diet or fitness regime.

Dry skin is another side effect of smoking. No matter how much expensive moisturiser you slap on, smoking more than 10 times a day will continue to reduce the moisture levels in your skin, leaving it parched and more prone to irritation.

Will it cause spots or breakouts?

You may find yourself suffering from adult acne as a result of smoking. A study published in the Dermato Endocrinology journal looked at 1,050 women and found that smokers were more likely to have adult acne than non-smokers.  The scientists behind the study believe that cigarette fumes affect oil production in your skin leading to the possibility of acne.

How can we stop this?

So, it’s pretty clear that smoking is bad for your skin. But, on the bright side, if you stop smoking, you’ll prevent further deterioration.  And within just two weeks of quitting your circulation will start to improve, bringing more oxygen to your skin and a better, brighter complexion.

For information on how to quit contact NHS Wales’ Help Me Quit service on 0808 085 2219

or by visiting www.helpmequit.wales.

Is smoking bad for your hair?

Did you know that as a smoker you could be doing serious damage to your hair?
Every time you light up a cigarette your hair is surrounded by a cloud of toxic fumes, which scientists say can lead to premature baldness and going grey. Here are some of the reasons why quitting smoking is better for your hair: 

Brittle hair

Cigarettes contain 4,000 different chemicals and gases so it’s no surprise that smoking affects the quality of your hair, which will be filled with toxic fumes every time you light up. Smoking also restricts the amount of oxygen your cells can carry around your body which means your hair is not supplied with enough nutrients or fresh oxygen from your blood stream.  As a result many smokers have dry, brittle hairs that snap off before they are fully grown because they have become malnourished.

Going grey

Scientists believe that smoking may accelerate premature grey due to the toxins in the smoke that can harm hair follicles and damage hormones. A report published in the British Medical Journal, which studied 600 men and women half of whom were smokers, found  a ‘consistent link’ between smoking and early graying of the hair.

Baldness

Smoking has been linked to baldness. A study carried out in Taiwan, and published in the Archives of Dermatology, found that smoking at least 20 cigarettes a day was linked to an increased risk of baldness. The researchers suggested that this may be because smoking damages hair follicles and causes damage to the cells at their roots.

Third-hand smoke

Third-hand smoke is the name given to the toxins and particles that cling to furniture and fabrics, long after you’ve stubbed out your cigarette. Hair, which is highly absorbent, soaks up these particles so that even the most fragrant of  shampoos won’t disguise the stink of cigarette smoke in your hair and the hair of those who are near you when you smoke.  Only giving up smoking completely will improve the smell of your hair.

How good timing can maximize your chances of giving up smoking

THERE’S no perfect time to stop smoking. However, by following these basic rules, you can boost your chances of success.

Steer clear of stress

It’s best not to coincide your quit attempt with stressful situations in your life. Most smokers light up because they believe smoking helps them to relax. If you’re one of them then you’re more likely to cave in and start smoking again if you try to quit when facing challenging events. Obviously it’s impossible to predict when life will become stressful, or to avoid stress altogether, but if you know a stressful event is looming on the horizon, then think twice before deciding to quit at that time.

Party time

Lots of smokers quit in the New Year and there’s a good reason for that – the party season is over.
Temptation lies around every corner during big social events, from the crowds congregating for a communal smoke outside, to the urge to have a smoke with a drink in your hand.  If you’re a social smoker who tends to smoke while socialising, it’s particularly important to think about whether to quit smoking during the festive party season as you may find it harder to resist the temptation to light up. Likewise, if you have a big family event, wedding or party coming up then time your quit attempt wisely.

Holiday showdown

Booking a holiday is a fantastic way to celebrate quitting smoking and a great way to spend that extra cash you’ll save as a result. However, if you give up  during your break, the urge to have a cigarette while sipping your evening cocktail may prove too much. And while holidays are supposed to be a time to relax, they can prove stressful, particularly those involving children or extended family.  So why not wait until you’re home or delay booking your break until you’ve actually given up.

 Out of office

Smoking can become a big part of people’s daily routines. A cigarette in the morning before breakfast, smoking on the way home after work and taking smoking break with colleagues are hard habits to break. If you work and are serious about quitting, you could consider booking a few days off work to break up your usual routine and improve your chances. Quitting smoking while you’re off work will mean you can really focus on your goal and combat your cravings away from the stresses and distractions of working life.

Preparation is everything

When it comes to planning your quit attempt good preparation is key. Set a date and stick to it. Once you’ve decided on the date then plan what you’ll need in place to help you quit. If you’re going to use nicotine replacement therapy to cope with nicotine cravings, make sure you research what products are available and collect some in advance so that it’s there when you need it.  Your GP and pharmacist can help you to decide what to take. If you’ll be quitting using an e-cigarette, visit your local vape shop and buy a starter pack to get you going.

Tell friends and family in advance that you’re planning to give up so they can be there to provide support and motivation if you need it. Plan activities to distract you from cravings and decide on  a coping strategy if you find yourself in a situation where you’re tempted to smoke.

Nicotine addiction and the unconscious brain

Nicotine is the addictive stimulant within tobacco cigarettes and the chemical which changes your brain chemistry and habits. Nicotine will get you addicted to tobacco cigarettes however the most serious health problems are caused by other ingredients which include formaldehyde, cyanide, ammonia and tar.

Do you have a daily smoking routine?  Most smokers say they get an urge for a cigarette at particular times of the day e.g after breakfast, drinking coffee, waiting at the bus stop.

This is a result of the nicotine changing your brain chemistry, which then changes your daily routine.

When you carry out every day activities and have a cigarette your subconscious brain remembers the nicotine hit and the release of the feel-good chemical dopamine. The nicotine nudges your brain to produce dopamine and an adrenaline rush which then becomes associated with that activity. The drug and the action become interlinked without you even knowing.

Smokers often struggle when trying to quit as the nicotine hit is gone but the daily habits and rituals are still there. Alongside treating the physical cravings, we also need to address these patterns of behaviour that the unconscious brain has associated with smoking.

If you’re trying to quit – try changing your routine or finding alternative activities that don’t trigger the urge to light up a cigarette.

Morning Routine

If you get the urge to smoke first thing in the morning you could try taking a shower immediately when you get up or make a cup of tea to keep your hands busy. Try to find an activity that both rewards and distracts the brain.

At Work

If you’re used to going out for a smoke break with colleagues, perhaps ask a non-smoking colleague if they’d like to join you for a brisk walk instead. Make sure to do this away from the smoking area and you’ll still get that reward of social time, just without the cigarette.

Out Socialising

If you usually have a cigarette whilst out socialising, try avoiding designated smoking areas outside buildings. Tell your friends and family about your decision and ask for their support to help with the social pressure. Alcohol is a known smoking trigger, maybe try cutting back on alcohol in the first few weeks after quitting, or make sure to go out with others who can support you to stay smokefree and remind you why you decided to quit, as alcohol often effects our sense of judgement.

FALSE – Nicotine will get you addicted to tobacco cigarettes however the most serious health problems are caused by other ingredients which include formaldehyde, cyanide, ammonia and tar.

]If you’ve quit smoking or are thinking about quitting take note of the times of day when your craving for a cigarette is at its highest. Once you start to take note of this behaviour it will be far easier to manage once you’ve quit. It is also important to remember that these small lifestyle changes don’t have to last forever, but alongside treating the physical addiction they will help you to control the unconscious brain and break the daily habits which tend to keep people smoking.

Welsh teens share their smoking struggles with ASH Wales

Across Wales 9% of 15 to 16-year-olds smoke and this figure hasn’t changed for 4 years, a classroom’s worth of children still take up the habit every day.

ASH Wales spoke to Abi and Sophie from Bridgend who started smoking at the ages of 14 and 12, to find out more about why young people continue to smoke in Wales and the challenges they face when trying to quit.

Sophie, 17,

I started smoking when I was around 12 and a half. I was out with my friends who smoked and I was having family issues at the time. I found that it helped with my stress levels

I suffer with depression and if I wake up in a bad mood I’ll smoke around 25 to 30 fags a day. On a good day I’ll smoke 15 to 20 cigarettes a day. It really improves my mood.

Usually I get my friends to buy fags for me because I look young for my age and there are shops that won’t serve me but they will serve them even though they are the same age.

I spend my wages on cigarettes and I know I’d have a lot more spare cash if I didn’t smoke. I’d spend it on clothes, shoes, make up and going out with the girls instead.

I did manage to give up for six months a while ago, but I started again because I had family problems.

Most people who know me say they never would have guessed that I’m a smoker. I hate smoking, I despise it. It’s a dirty habit, but I rely on it for my mental health.

I was shocked to hear that 17% of people in Wales smoke. I thought it would be more like 70% because everybody around me smokes. It’s a lot harder to quit when everybody else in your family does it.

It’s definitely starting to affect my health. We have to go up two flights of stairs to get to the top floor at our training centre and by the time I reach the top I’m gasping for breath.

Abi , 17

I was 14 when I started smoking. My father had passed away and everybody around me was smoking and I just thought it was a cool thing to do.

It’s a dirty habit and it makes your clothes smell of smoke. But I can’t help it now because I’ve been smoking for so long.

I do it more when I’m stressed. If it’s a bad day, I’ll smoke around 15 to 20 cigarettes a day and on a good day it will more like 10 to 15.

Every week I spend around £20 on cigarettes and I usually ask my partner to buy them for me.

I once smoked an illegal cigarette, but it was disgusting. You could really taste the chemicals in it.

I’ve definitely got less money than if I didn’t smoke. I’ve tried to quit using nicotine spray but I didn’t like it. In future I’m planning to try again but I’ll cut down the amount I smoke first, not just quit straightaway.

Around here everybody smokes. Literally there are people smoking everywhere, and it makes you want to have a fag even more. All my family and friends smoke too.

I don’t think there are enough resources available to help young people to stop smoking. I didn’t know that you could get help from a pharmacist to give up.

I think it would put people off if they made the age you could buy a cigarette 21 instead of 18.

Find out more;

Smoking and mental health 

Smoking and young people