BabyBreathe: 57.6% smoke-free 12 months after birth, as intended

At routine health visitor appointments after a baby is born, a quit-smoking success can easily become invisible. BabyBreathe is designed to keep it visible: in a large randomized trial, 57.6% of women who received the program as intended were still smoke-free 12 months after giving birth, compared with 49.9% receiving usual care.

The program was developed by researchers at the University of East Anglia, led by Caitlin Notley of UEA’s Norwich Medical School, with partners including the University of Edinburgh, the University of Exeter and the Institute of Health Visiting. It adds relapse-prevention advice to the existing health visitor relationship, rather than treating childbirth as the end of smoking support.

The package combines one-to-one guidance from trained health visitors with text messages, a dedicated website and app, and a relapse-prevention kit sent immediately after birth. Women received advice on alternatives to try when cravings returned, while partners and family members were also given advice. Support continued at routine health visitor appointments for up to 12 months postpartum.

The result comes from 886 women in England and Scotland who had successfully stopped smoking before or during pregnancy. Participants were randomly assigned to BabyBreathe or usual care, which provided no advice or support specifically aimed at preventing relapse. But the program was not delivered as intended for around one in five participants, because of workforce pressures, missed appointments or administrative problems.

So, concretely, the study points to a practical extension of support for mothers who have already quit: trained health visitors could help more women protect that change after birth, with potential benefits for mothers, babies and families through less exposure to secondhand smoke. The researchers also say the participant group was more highly educated and less socioeconomically deprived than the wider population, so the result may not apply equally everywhere.