ArticleTobacco control2018
Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: interrupted time series analysis with economic evaluation.
Article in Tobacco control, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- A systematic review of interventions to increase the use of smoking cessation services for women who smoke during pregnancy.The Australian & New Zealand journal of obstetrics & gynaecology · 2023Pooled it
- Systems approach to health service design, delivery and improvement: a systematic review and meta-analysis.BMJ open · 2021Pooled it
- Trial
- Trial
- Harnessing routinely collected data for the evaluation of early years interventions: insights from a scoping review of evaluation studies.International journal of population data science · 2026Article
- Development of an intervention for smoking cessation in pregnant women using a theory-based approach.BMC pregnancy and childbirth · 2025Article
- Using natural experiments to evaluate population health and health system interventions: new framework for producers and users of evidence.BMJ (Clinical research ed.) · 2025Article
- A scoping review of costing methodologies used to assess interventions for underserved pregnant people and new parents.International journal for equity in health · 2024Article
- The MOHMQuit (Midwives and Obstetricians Helping Mothers to Quit Smoking) Trial: protocol for a stepped-wedge implementation trial to improve best practice smoking cessation support in public antenatal care services.Implementation science : IS · 2022Article
- Accessing specialist support to stop smoking in pregnancy: A qualitative study exploring engagement with UK-based stop smoking services.British journal of health psychology · 2022Article
- Isolation, marginalisation and disempowerment - understanding how interactions with health providers can influence smoking cessation in pregnancy.BMC pregnancy and childbirth · 2022Article
- Internet of things in healthcare for patient safety: an empirical study.BMC health services research · 2022Article
- Smoking Cessation Support for Pregnant Women Provided by English Stop Smoking Services and National Health Service Trusts: A Survey.International journal of environmental research and public health · 2022Article
- Fetal growth restriction, low birth weight, and preterm birth: Effects of active or passive smoking evaluated by maternal expired CO at delivery, impacts of cessation at different trimesters.Tobacco induced diseases · 2022Article
- Improving implementation of smoking cessation guidelines in pregnancy care: development of an intervention to address system, maternity service leader and clinician factors.Implementation science communications · 2021Article
- Article
- Improving Clinicians' Implementation of Guidelines to Help Women Stop Smoking in Pregnancy: Developing Evidence-Based Print and Video Materials.International journal of environmental research and public health · 2021Article
- Article
- Smoking and drinking habits of women in subsequent pregnancies after specific advice about the dangers of these exposures during pregnancy.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2020Article
- Acceptability of a cessation intervention for pregnant smokers: a qualitative study guided by Normalization Process Theory.BMC public health · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 3 countries.
Funding
Abstract
objectivesTo evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking.
designInterrupted time series analysis of routine data before and after introducing the intervention, within-study economic evaluation.
settingEight acute NHS hospital trusts and 12 local authority areas in North East England.
participants37 726 records of singleton delivery including 10 594 to mothers classified as smoking during pregnancy.
interventionsA package of measures implemented in trusts and smoking cessation services, aimed at increasing the proportion of pregnant smokers quitting during pregnancy, comprising skills training for healthcare and smoking cessation staff; universal carbon monoxide monitoring with routine opt-out referral for smoking cessation support; provision of carbon monoxide monitors and supporting materials; and an explicit referral pathway and follow-up protocol.
main outcome measuresReferrals to smoking cessation services; probability of quitting smoking during pregnancy; additional costs to health services; incremental cost per additional woman quitting.
resultsAfter introduction of the intervention, the referral rate increased more than twofold (incidence rate ratio=2.47, 95% CI 2.16 to 2.81) and the probability of quitting by delivery increased (adjusted OR=1.81, 95% CI 1.54 to 2.12). The additional cost per delivery was £31 and the incremental cost per additional quit was £952; 31 pregnant women needed to be treated for each additional quitter.
conclusionsThe implementation of a system-wide complex healthcare intervention was associated with significant increase in rates of quitting by delivery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.