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🧵(1/21) on research & policy. Today @NeilDotBrien (Minister for Primary Care & Public Health) announced the roll out of a national incentive scheme in 🏴 for #smokingcessation in #pregnancy. This is underpinned by 20 years of studies & teamwork. Reflections on #lessonslearned
Building the evidence for prevention policies like this take time, but if the evidence is robust, wider societal shifts are in favour, you work with funders, respected #advocacy partners, research participants and experienced civil servants it can happen. gov.uk/government/new…
2003. I was a lecturer @uofglasgow. I met an experienced paediatrician, Prof David Tappin. He had worked for years w. @CotDeathTrust & was committed to reducing still births & infant mortality. He knew smoking in pregnancy harmed mothers & babies & wanted to do more to prevent it
Most women who smoke quit when they find out they are pregnant. But that can be very difficult. If you have little money, poor support, a partner who smokes and maybe your own mother did in pregnancy, it’s not easy. onlinelibrary.wiley.com/doi/full/10.11…
Early studies in the USA of providing women with a small incentive, and sometimes their partner also remember, these are often couples with limited resources) were promising. Systematic review of studies up to 2010 here: sciencedirect.com/science/articl…
2005 David & I & others started to work with @theGCPH where the Director, Prof @CarolTannahill, was interested in finding out more about why smoking in pregnancy rates were so much higher in deprived areas we started several years work with GCPH & @NHSGGC gcph.co.uk/children_and_f…
2007 an early pioneer, Dr Andrew Radley @AndrRadl (Consultant in PH @NHSTayside) set up ‘Give it Up for Baby’ providing a £15 ASDA voucher to pregnant women who signed up to stop smoking service support. Local evaluation findings supported his approach. nhstayside.scot.nhs.uk/OurServicesA-Z…
2006-2012. Our early work with @TheGCPH progressed to a pilot trial co-funded by @CSO_Scotland involving 612 pregnant smokers in Glasgow. Results were hugely promising. Results here: bmj.com/content/350/bm…
We involved health economists Prof Andy Briggs & @Kathleenannboyd. They found that incentives - staged throughout pregnancy & amounting to £400 resulting in over double the quit rate at end of pregnancy compared to usual care were cost effective onlinelibrary.wiley.com/doi/10.1111/ad…
2012. A pilot trial isn’t usually enough to change guidance. The Smoking in Pregnancy Challenge Group, coordinated by @ASHOrgUK @HazelCheeseman took up the mantel & is a tireless advocate for change. Honoured to still co-chair this w @CHarmerSands smokefreeaction.org.uk/smokefree-nhs/…
The Challenge Group highlighted work in practice on incentives set up by Andrea Crossfield in the previous regional office for TC in North West England & then progressed at rapid scale across Greater Manchester by @HistoryMakersGM @Coyne4Jane. smokefreeaction.org.uk/wp-content/upl…
2014. Our pilot trial was merged w results of other studies in a @CochraneTAG review (then updated 2017) finding financial incentives were the single most effective intervention to stop pregnant women smoking, particularly when combined behavioural support cochrane.org/CD001055/PREG_…
But we knew a multi-centre trial was needed to change practice. To show that what was found at feasibility & pilot (to follow @The_MRC guidelines) could be transferred to many diff settings & still yield similar results. Securing the funding for this took another several years.😫
2015-17 Cancer Research UK @CRUKResearch, who I was working with, listened & encouraged us to submit an application for competitive funding. This was a rigorous process & the science needed to be top notch. We secured half the funding from them & this helped us approach others.
We then secured the remainder of the funds to proceed @CS0_Scotland @HSC_NI @Nichstweet @CotDeathTrust @LullabyTrust - all subject to competitive peer review and appropriate funding committee deliberations. Plus @SPECTRUMRes @UK_PRP for my time to co-lead the trial.
2017-21 The multi-centre trial was conducted in 7 centres in 🏴, Northern Ireland & 🏴. Huge thanks to Lesley Sinclair trial manager & all those who contributed. We found incentives were still more than 2x as effective for cessation as usual care bmj.com/content/379/bm…
2021: The national health care guideline committee in England @NICEComms considered our pilot trial & (at the time pre-publication) multi-centre trial results, along w @CochraneTAG findings & recommended that incentives be added to stop smoking support nice.org.uk/guidance/ng209…
Throughout there was tireless work by highly experienced civil servants like @Rosanna_OConnor @Switchfinder & many others who worked with different Ministers over years to continue to make the case for effective tobacco control measures & use research evidence to inform action.
2023: National scheme announced *If implemented properly* it will result in NHS savings & better outcomes for mothers & families. When we started this work, my children were babies. They are now young adults. Making the case for prevention takes time, but it is time well spent.
Key reflections from this v long🧵
Researchers can think generating good quality evidence is enough. It's not. It's the relationships, the networks, the funders, practitioners, advocates & participants. What they do is what actually achieves change & makes the research useful 🙏
Researchers can think generating good quality evidence is enough. It's not. It's the relationships, the networks, the funders, practitioners, advocates & participants. What they do is what actually achieves change & makes the research useful 🙏
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