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Researchers from the NIHR ARC for the North East and North Cumbria have evaluated the effectiveness of an app which supports expectant mothers to quit smoking.

Smoking during pregnancy continues to decline across England. However, in the North East and Cumbria, we have a higher percentage of mothers still smoking at the time of birth, compared to the national average.

Researchers worked with colleagues from the Local Maternity System, Fresh, North East and North Cumbria Integrated Care System Prevention Board, and North of England Commissioning Support to evaluate the implementation of and engagement with the NHS Smoke Free App in our area.

The research took place between 2020 and 2022.

Key findings and recommendations

The uptake of the Smoke Free app was low, which was influenced by several factors relating to implementation and engagement. Despite a significant amount of support to embed the app as part of routine services, the impact of the Covid-19 pandemic onto Maternity and Health Visiting services staffing pressures and work priorities have obstructed professionals’ ability to implement the app.

The app download process and limited instructions on how to navigate or maximise use of the features may have been a barrier to access. Interestingly, user data show that the app had been primarily accessed by the most deprived populations. However, there are also higher numbers of non-pregnant adult female smokers from the most deprived populations. Whether these groups prefer digital support over face-to-face was not explored within this evaluation.

Recommendations include – where possible, a named, in-person smoking cessation supporter should be provided to pregnant individuals. The remaining unused licences should be or offered to other populations, e.g., general adult smokers, targeting areas of high deprivation and high smoking where this is demonstrated to be more successful. Should the Smoke Free app continue to be used for the pregnant population and their partners, future promotions should be aligned with existing campaigns; social media campaigns should be targeted based on demographic characteristics (e.g., postcode, age) and downloads should be facilitated at the point of referral. Implementation of digital innovations should be accompanied by robust evaluations to overcome barriers to engagement and assess intervention effectiveness.

You can download the full evaluation report below.

For more information about the Smoke Free app, visit www.smokefreeapp.com