The University of East Anglia (UEA) has reported that women who received enhanced postnatal support from trained health visitors alongside the BabyBreathe programme were more likely to remain smoke-free for 12 months after childbirth than those who did not receive that one-to-one support.
Study focus and intervention
The research, funded by the National Institute for Health and Care Research (NIHR) and published in the BMJ, evaluated BabyBreathe — a multifaceted relapse-prevention package for women who quit smoking during pregnancy or immediately beforehand. The programme combines:
- face-to-face, individual support from trained health visitors;
- digital tools including a website and an app;
- text message follow-up; and
- a relapse-prevention kit sent to families after birth.
Researchers tested whether adding structured support from health visitors improved the chances that women would remain abstinent from tobacco at one year postpartum.
Findings and expert comment
According to the study team, participants who received the BabyBreathe intervention delivered as intended — particularly the direct input from health visitors — were significantly more likely to be non-smokers at 12 months after delivery than women who did not benefit from that level of personal support.
"Quitting smoking during pregnancy is an incredible achievement, but staying smoke-free after a baby is born can be just as challenging," said lead researcher Prof Caitlin Notley of UEA's Norwich Medical School.
Prof Notley and collaborators, including several universities and the Institute of Health Visiting (iHV), emphasised that sustained, proactive follow-up in the postnatal period appears central to preventing relapse.
Public health implications
Stopping smoking in pregnancy is well established to reduce risks such as low birth weight and stillbirth, and maintaining abstinence benefits both the mother’s long-term health and the child’s exposure to second-hand smoke. The study reinforces the point that initial cessation during pregnancy does not guarantee permanent quitting, particularly once new mothers face the stresses and sleep disruption of early parenting.
The authors argue the findings support investment in training health visitors in smoking relapse prevention so they can offer targeted, evidence-based support to families during routine visits. This is pertinent for NHS and local authority planning: health visitors form a core element of the early-years public health workforce and are uniquely positioned to deliver follow-up care in the home.
Limitations and next steps
The research reports a positive association between health-visitor-supported delivery of BabyBreathe and sustained non-smoking after childbirth, but as the authors note, broader rollout would require examining implementation at scale, workforce capacity and cost-effectiveness across diverse local contexts. The study does not claim the intervention is a panacea; rather it identifies an effective component — trained, ongoing contact — that merits incorporation into postnatal care pathways and further economic evaluation.
| Programme component | Role |
|---|---|
| Health visitor support | One-to-one, tailored relapse prevention and follow-up |
| Digital tools (app/website) | Information, reminders and self-help resources |
| Text messages | Ongoing prompts and encouragement |
| Relapse-prevention kit | Practical aids sent after birth |
For clinicians and policymakers, the study suggests a practicable route to reduce postpartum smoking relapse: better equipping health visitors to deliver relapse-prevention interventions as part of routine postnatal contact. Further research should quantify the potential reductions in smoking-related disease and the resources needed to scale up training and delivery nationally.
In short, the UEA trial strengthens the evidence that sustained, person-centred support after birth can help women retain the health gains of quitting during pregnancy — with benefits for mothers and their babies.
