Smokefree

MICHELLE LEE 

Team Leader, Living Smokefree Service

Promoting smoke-free pregnancies is a key initiative, which could have a major impact on improving health outcomes for infants born to women living in Counties Manukau.

Smoking during pregnancy is associated with a number of adverse pregnancy outcomes, including miscarriage, placental abruption, intrauterine growth restriction, premature delivery and stillbirth.* In addition, smoking during pregnancy has been associated with an increased risk of neonatal death, particularly as a result of sudden unexplained death in infancy.

Of all the women birthing at CM Health in 2020, 12 per cent (917) were smoking at the time of their admission for birth. This is a decrease in prevalence of 2 per cent compared to last year, and a reduction of 143 women smoking from last year.

There were marked ethnic differences in the smoking statistics, with 38 per cent of Maaori women identified as currently smoking (1 per cent lower than the previous year), compared to 9 per cent of Pacific Island women (3 per cent lower than the previous year), and 4 per cent of European, Asian and other women; see Table 17.

Smokefree maternal incentive programmes

The Smokefree Pregnancy Incentives Programme has been operating in Counties Manukau since 2013, and continues to achieve high success rates.

In 2020, 218 women successfully stopped smoking with the service, compared to 160 in 2019. (Women’s smoke-free status is validated by carbon monoxide testing). Just over half (53 per cent) of these successful smoke-free pregnancies are Maaori, 34 per cent Pacific and 13 per cent other ethnicities.

In addition, the Smokefree Postnatal Incentives Programme has been running since 2017 to help women avoid a relapse to smoking following their birth.

Some key results for the programmes in 2020 are given below.

• We received referrals for approximately 70 per cent of the women who were recorded as smoking at the time of booking with a midwife: 60 per cent of referrals were for NZ Maaori and 30 per cent Pacific women.

* US Department of Health and Human Services. (2014). Surgeon

General’s report: The health consequences of smoking—50 years of progress. Retrieved from http://www.surgeongeneral. gov/library/reports/50-years-of-progress/full-report.pdf

Please Remember: Refer ALL pregnant women who smoke for Smokefree support

to give baby the best start in life

0800 569 568 or 021 807093 Smokefree@middlemore.co.nz

You can make a difference

TABLE 17 

Number of women, by smoking status and ethnicity, who birthed at a CM Health facility, 2020

SMOKING STATUS

NZ MAAORI PACIFIC ISLAND EUROPEAN/ OTHER ASIAN TOTAL

Currently smoking

Nonsmoker

563 221 120 13 917

863 2,252 1,334 1,782 6,231

Unknown 62 80 61 41 244

Total 1,488 2,553 1,515 1,823 7,379

• We received around 20 more referrals than in 2019, but a significantly higher number of waahine were assessed. This was partially due to the programmes using more phone assessments, after these were introduced during COVID-19 alert levels 3 and 4.

In total, 484 assessments were completed in 2020, compared with 338 in 2019.

• A total of 218 waahine hapuu successfully stopped smoking with the programme; an increase of 60 more waahine hapuu being smoke-free at 4 weeks, compared with 2019. We achieved an 85 per cent quit rate for all ethnicities. • There was a larger focus on addressing holistic and wellbeing needs. For example, we referred 264 women for safe-sleep devices, 52 for healthy housing assessments, 119 for breastfeeding support, 19 for antenatal classes, 115 for free dental appointments and 24 women who had continue to drink during pregnancy were provided with support to stop.

• There was a 20 per cent increase in whaanau enrolling to support hapuu maamaa.

We wish to give a huge acknowledgment to whaanau taking on this wero, and winning and allowing us to be part of their journey.

Proactive referring

Our proactive referral approach has result in us receiving referrals for approximately 70 per cent of the pregnant women in Counties Manukau who smoke.

Under this approach, all referrers are encouraged to refer all women who smoke, and allow the Smokefree service to have the longer conversation with women about stopping, using motivational interviewing to encourage engagement. In 2020, a greater number of GP practices sent through lists of waahine hapuu who smoke, enabling us to engage with women who either had not accepted a referral from their midwife or had not disclosed their smoking status. This led to 53 extra referrals being received and 24 extra women successfully becoming smoke-free.