Health Support Keeps Mothers Smoke-Free

Evaluating the BabyBreathe Postpartum Cessation Program

The randomized controlled trial enrolled 886 women from England and Scotland who successfully stopped smoking before or during pregnancy. Participants were divided to receive either the specialized BabyBreathe intervention or usual care, which offered no specific advice or targeted support to prevent smoking relapse. For participants who received the intervention as intended, 57.6% remained smoke-free at 12 months in the BabyBreathe group, compared to 49.9% for those receiving usual care.

“Quitting smoking during pregnancy is an incredible achievement, but staying smoke-free after a baby is born can be just as challenging,” said Caitlin Notley, professor of addiction sciences at UEA’s Norwich Medical School, in a news release. “Too often, support ends once a woman has quit, even though the stressful months after birth are when many women are most at risk of returning to smoking. Our research shows that when health visiting services are trained and supported to deliver specialist relapse prevention advice, they can make a real difference.”

Multimodal Support Model and Health Visitor Integration

The BabyBreathe scheme provides a comprehensive suite of resources. This multimodal model combines one-to-one support from trained health visitors with digital tools, including a dedicated website and app, text message support, and a physical relapse-prevention kit sent to families after birth. Support continued for up to 12 months postpartum during all routine health visitor appointments, offering advice on alternatives to smoking during urges and guidance for partners and family members.

“Health visitors and their teams are uniquely placed to support women in preventing smoking relapse as part of their universal offer,” said Vicky Gilroy, director of innovation and research at the Institute of Health Visiting (iHV). “The findings reinforce the need for all health visitors to receive training in this important area.”

Study Limitations and Practical Implementation Challenges

Researchers noted several operational hurdles during the trial. The BabyBreathe program was delivered incompletely for approximately one in five participants due to workforce pressures and administrative issues. Furthermore, the participant group featured higher education levels and lower socioeconomic deprivation than the wider population, which may affect how findings apply more broadly.

“Our BabyBreathe study enrolled pregnant women who had quit smoking and showed great promise that a postpartum health visitor support package, if delivered as intended, could make a real difference to supporting them to stay off cigarettes,” said Richard Holland, professor of public health medicine and dean at the University of Exeter Medical School, in a news release.

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