Helping more women stop smoking in pregnancy: learning from what works

Saving babies’ lives is multifaceted. There is no single intervention that does it all. It takes good care, trusted relationships, practical support and a willingness to keep learning.

In my work, I’m always asking: what is working? What could we do better? Are we making it easier for women to access support that makes a difference?

That curiosity led me to look more closely at vaping and stopping smoking within Greater Manchester’s maternity stop smoking services.

Looking at what happens in practice

We know how important stopping smoking is during pregnancy. We also know that knowing the risks does not make quitting easy.

Women are managing nicotine dependence alongside everything else happening in their lives. For some, that includes financial worries, stress, poor mental health or living with other people who smoke. Our support needs to recognise those realities.

I wanted to understand whether women recorded as vaping were having different quit outcomes from those recorded as not vaping.

Looking back at service records from January 2025 to June 2025, the evaluation included 276 pregnant women with a recorded four-week quit outcome.

The difference caught my attention:

• 84% of women recorded as vaping had stopped smoking at four weeks.

• 52% of women recorded as not vaping had stopped smoking at four weeks.

That is an encouraging finding, and one I think is worth exploring further.

It is also important to be clear about what it tells us. This was a small observational study using routine service records. It shows an association, but it cannot prove that vaping caused the difference. Women in the two groups may have differed in other ways that affected their chances of quitting.

Being clear about what we are trying to achieve

One distinction matters here: stopping smoking does not necessarily mean stopping vaping or nicotine.

Some women counted as having quit smoking were vaping. That does not undo their achievement in stopping tobacco smoking.

This is where harm reduction comes in. For me, in this context, it means helping pregnant women move away from the harmful exposure caused by smoking, while recognising that stopping all nicotine use may not be immediately achievable.

Smoking burns tobacco and produces carbon monoxide, a harmful gas that reduces the oxygen reaching a developing baby. NHS advice states that vapes do not produce tar or carbon monoxide and that using a vape to stop smoking is much safer than continuing to smoke. Vaping is not risk-free, but it should not simply be treated as another form of tobacco smoking. 

The aim is to help women stop smoking completely and stay smoke-free, with support that works for them.

Staying curious about the findings

I don’t see this evaluation as the final answer. I see it as a reason to keep asking questions.

Did women remain smoke-free later in pregnancy and after birth? What support did they find most helpful? What made the difference when previous quit attempts had been difficult?

We also need clearer information about when vaping was recorded, how quitting was confirmed and how missing or repeat records were handled.

This evaluation did not measure babies’ health outcomes or demonstrate cost savings. Those are important questions for future work.

Research trials, reviews, everyday service data and women’s own experiences all have something to contribute. Looking at them together helps us understand where the evidence is pointing and where uncertainty remains.

Keeping improvement at the heart of the work

For me, improving maternity care means being willing to look closely at what we do, listen to women and learn from the results.

These findings give us something useful to build on. They suggest that vaping may have a role in helping some pregnant women stop smoking within specialist support services, and that this deserves further evaluation.

Saving babies’ lives involves many connected pieces of work. Helping more women achieve a smoke-free pregnancy is one of them.

I want us to keep learning, keep improving and keep making that support as accessible and effective as we can.