Contracting for smoking and pregnancy interventions: current practice across England

Area of Science:

• Public Health
• Health Services Research
• Maternal Health

Background:

• The commissioning of smoking and pregnancy interventions in England prior to 1998 lacked a unified national strategy.
• Understanding the pre-strategy landscape is crucial for evaluating subsequent policy impacts.

Purpose of the Study:

• To assess the state of smoking and pregnancy intervention commissioning across England before the 1998 "Smoking Kills" strategy.
• To identify types of interventions, contract agreements, barriers, and data collection practices.

Main Methods:

• A postal survey was conducted among all 96 Health Authorities (purchasers) and 207 Maternity Service Provider Units in England.
• Data collected focused on contract agreements, intervention nature and complexity, barriers, and monitoring.

Main Results:

• Only a quarter of health authorities used contract agreements to encourage smoking cessation.
• Interventions were diverse and ad hoc, with significant variation in contract complexity.
• Data collection and monitoring were inconsistent, hindering comparisons.

Conclusions:

• Smoking cessation interventions for pregnant women were inadequately prioritized in England before 1998.
• The study provides a baseline for assessing changes following the implementation of the national tobacco strategy.