A state-wide approach to helping Aboriginal pregnant women give smokes the flick

Smoking during pregnancy contributes to an increased risk of a broad range of obstetric and infant complications, including spontaneous abortion, pregnancy and labour complications, stillbirth, low birth weight (small and sickly baby) and sudden infant death syndrome. In addition to these risks from maternal smoking, exposure to second-hand tobacco smoke is also a risk during pregnancy and harms both the mother and the developing baby.

The rate of smoking during pregnancy is high among women who identify as having an Aboriginal baby. In 2019 HealthStats NSW reported that 43.2 per cent of NSW Aboriginal women smoked during pregnancy compared to 7.1 per cent of non-Aboriginal women.

The NSW Government is committed to closing the gap in pregnancy smoking rates between Aboriginal and non-Aboriginal women in order to give Aboriginal children the best start in life.

Quit for new life is a smoking cessation program for women having an Aboriginal baby. The program, which finished on 30 June 2018, aimed to address the high rate of smoking during pregnancy and prevent relapse to smoking after birth. The program was a joint initiative of the NSW Ministry of Health and NSW Kids and Families. It provided culturally appropriate smoking cessation support to Aboriginal pregnant women and their household members who smoke, including advice, behavioural strategies, referral to Quitline, up to 12 weeks free nicotine replacement therapy, and extended follow-up support.

Sustaining practice: case studies of three promising services models

A four-minute long video and complementary short report made in 2019-2020 share how three different services worked to sustain support to reduce the harms of smoking on mothers and babies. The video and report may help other services consider how to sustain best practice cessation support that were introduced under Quit for new life.

Snapshot report: Quit for new life - Promising service models

How the program was supported

• Committed funding from the NSW Ministry of Health of $8.4M over five years for the planning, promotion, implementation and evaluation of the Quit for new life program across NSW.
• Phased roll out through local health districts (LHDs), commencing January 2013 with all 14 LHDs on board by February 2015.
• Full day training program offered to all LHDs, facilitated by the NSW Health smoking cessation trainer.
• A voucher system for providing free nicotine replacement therapy (NRT) to Aboriginal women and their household members who smoke, redeemable through community pharmacies across NSW.
• A strong focus on practice change and capacity building by embedding best practice smoking cessation for Aboriginal pregnant and postnatal women into routine care delivery.
• Regular monitoring of key indicators and reporting by LHDs.
• Comprehensive state-wide evaluation to provide valuable data on the impact of the program on smoking and quitting behaviour of Aboriginal women during pregnancy.

Services that offered Quit for new life

• All Aboriginal Maternal and Infant Health Services (AMIHS) across NSW that provide antenatal care for women having an Aboriginal baby.
• Some mainstream hospital based antenatal clinics.
• A range of postnatal/child and family health services.

Some Aboriginal Community Controlled Health Services were also involved in the Quit for new life.

For more information on the Quit for new life program, download a copy of the Quit for new life handbook.