Will all pregnant women be made to take a breath test to see if they smoke?
Behind the headlines
Earlier this month, NICE received widespread media coverage for a piece of public health guidance on quitting smoking in pregnancy. Some reports claimed that the guidance would lead to pregnant women being put “under pressure” to take a breath test to check if they are telling the truth about their smoking habits.
Here we take a closer look at exactly what was recommended.
Will all mothers be made to take a carbon monoxide breath test?
The NICE guidance on quitting smoking in pregnancy and following childbirth does not call for midwives to force all pregnant women to take a breath test, but does recommend that pregnant women be encouraged to have their carbon monoxide levels tested to determine whether they smoke. However, the test is not compulsory and women can choose not to have it.
High carbon monoxide levels can be seen amongst active and passive smokers, so by testing the levels of all pregnant women, those who smoke or who are regularly exposed to second-hand smoke will see a physical measure of their exposure.
The use of the tests can help to ensure that pregnant smokers receive appropriate support to quit for the good of their unborn baby.
Women who smoke and are either pregnant or have recently given birth, should be offered a range of options to help them quit, including automatic referral to smoking cessation services and sensitive and non-judgemental support by professionals.
Professor Mike Kelly, Director of Public Health at NICE, says: “We've known for many years that smoking and passive smoking can cause serious illnesses like lung cancer. During pregnancy, smoking puts the health of the women and her unborn baby at great risk both in the short and long-term, and small children who are exposed to second-hand smoke are more likely to suffer from respiratory problems.
“One of our recommendations is for midwives to encourage all pregnant women to have their carbon monoxide levels tested and discuss the results with them.
“This isn't to penalise them if they have been smoking, but instead will be a useful way to show women that both smoking and passive smoking can lead to having high levels of carbon monoxide in their systems. It will also alert non-smokers with high carbon monoxide levels to possible CO poisoning, which can be caused by a faulty boiler or car emissions.”
What else does the guidance suggest?
Women should be routinely referred to NHS Stop Smoking services and provided with the NHS Pregnancy Smoking Helpline number.
They should be offered personalised help, support and information on how to stop smoking. Partners who smoke should also consider contacting NHS Stop Smoking services for help quitting.
Formal training is recommended for healthcare and smoking cessation staff to ensure advice is offered in a non-judgmental way.
The guidance also sets out a number of recommendations for NHS Stop Smoking Services when considering the use of nicotine replacement therapy (NRT), such as:
- Discussing the risks and benefits of NRT with pregnant women who smoke, use only if smoking cessation without NRT fails and use professional judgement when deciding whether to offer a prescription.
- Only prescribing NRT for use when a woman has stopped smoking. Only two weeks of treatment should be prescribed at any one time with subsequent prescriptions only given to women who can demonstrate they are still not smoking.
What do other experts think of the guidance?
Deborah Arnott, Chief Executive of Action on Smoking and Health (ASH), says: “We welcome the NICE guidance which is designed to be practical and encouraging and not to condemn pregnant smokers for their addiction.”
“Only a very small proportion of women smokers carry on smoking after getting pregnant, but those who do tend to be the heaviest and most addicted smokers who need support and help from healthcare professionals to quit.”
Jane Brewin, Chief Executive of baby charity Tommy's, adds:“The sooner women who are pregnant can give up smoking, the better. Every baby deserves the best start in life and those born to smokers tend be smaller and weaker than other infants. However, it's important pregnant women feel supported if they make the decision to quit, and are aware of the stop smoking services available to them."
Read more about guidance on 'Helping women to quit smoking during pregnancy'.
26 July 2010
This page was last updated: 27 July 2010