Health visitor support helps postnatal mothers stay smoke-free

Women who receive health visitor support alongside smoking relapse prevention advice are more likely to remain smoke-free after childbirth, according to new research.

The team, led by University of East Anglia (UEA) and involving the Institute of Health Visiting (iHV), tested ‘BabyBreathe’ – a programme designed to help women who quit smoking before or during pregnancy stay smoke-free after giving birth.

The scheme provides one-to-one support from trained health visitors with digital tools, text message support, a dedicated website and app, and a relapse-prevention kit sent to families after birth.

This major study published in the BMJ shows that women who received this intervention as intended, with support from trained health visitors, were significantly more likely to remain smoke-free 12 months after giving birth compared to those without health visitor support.

Vicky Gilroy, Director of Innovation and Research at the iHV, said:

“Health visitors and their teams are uniquely placed to support women in preventing smoking relapse as part of their universal offer.

“It has been a privilege to contribute to the BabyBreathe study and help develop the evidence of the importance of their role. The findings reinforce the need for all health visitors to receive training in this important area.”

Lead researcher Prof Caitlin Notley, Professor of Addiction Sciences at UEA’s Norwich Medical School, said:

“Quitting smoking during pregnancy is an incredible achievement, but staying smoke-free after a baby is born can be just as challenging.

“Too often, support ends once a woman has quit, even though the stressful months after birth are when many women are most at risk of returning to smoking.

“Our research shows that when health visiting services are trained and supported to deliver specialist relapse prevention advice, they can make a real difference by significantly improving women’s chances of staying smoke-free. That means better health for mothers, babies and entire families.”

How the research happened

A total of 886 women from England and Scotland who had successfully stopped smoking before or during pregnancy took part in the study, as part of a large-scale randomised, controlled trial.

Participants were randomly assigned to receive either the BabyBreathe intervention or usual care – the latter of which offered no advice or support to prevent smoking relapse.

Although BabyBreathe was not delivered as intended for around one in five participants during the trial, either due to health visitor workforce pressures, missed appointments or administrative issues, health visitors provided one-to-one tailored advice and support to women in the intervention group. This was delivered at the end of pregnancy and immediately after the baby was born.

This support included advice on alternatives to try if they experienced urges to go back to smoking, as well as advice for partners and family members, and access to specially designed digital resources including the BabyBreathe app and website.

A relapse prevention ‘kit’ was also posted to women immediately after the birth of their baby and support continued for up to 12 months postpartum, at all routine health visitor appointments.

The intervention was the result of more than a decade of research and development involving women, families, health professionals and researchers – who worked together to co-design, develop and test this practical support package.

‘Health visitors play an important role’

When researchers looked at participants who received the intervention as intended, 57.6% remained smoke-free at 12 months in the BabyBreathe group – compared to 49.9% for those with usual care.

These findings suggest that health visiting services could play a significant role in ensuring the consistent delivery of relapse-prevention support, therefore also supporting the health of the entire family by helping more mothers to remain smoke-free after giving birth.

Prof Notley said:

“Women of childbearing age who quit and stay non-smoking can reduce their risks of developing a smoking-related disease to almost the same level of risk as non-smokers.

“There are also great benefits for babies and children brought up by parents who do not smoke – in avoiding exposure to second-hand smoke, and in helping to prevent the next generation from taking up smoking.

“Until now, health visitors had no training on smoking relapse prevention. This meant that when women had made the extremely important – and difficult – health behaviour change of quitting smoking during pregnancy, no one picked up on this and gave them positive praise and support.

“This new approach extends the intensive support for initially quitting smoking that pregnant women are offered, going one step further to help women to stay smokefree in the long term.”

The researchers note several limitations of the study that impacted the primary analysis, including incomplete delivery of the BabyBreathe programme and low engagement with some of its components. The participant group was also more highly educated and less socioeconomically deprived than the wider population, which may have affected the programme’s overall effectiveness and limit how broadly the findings can be applied.

This research was led by UEA in collaboration with the Institute of Health Visiting (iHV), University of Edinburgh, City St George’s, University of London, University of Exeter, University of Stirling, Glasgow Caledonian University and the Norfolk 0-19 Healthy Child Service. These findings are part of a £1.5 million project funded by the National Institute for Health and Care Research (NIHR).

Read full paper in BMJ: Effectiveness of the BabyBreathe intervention for maintaining postpartum smoking cessation: multi-centre pragmatic randomised controlled trial

BMJ 2026; 394 doi: https://doi.org/10.1136/bmj-2026-100242 (Published 18 August 2026)
Cite this as: BMJ 2026;394:e100242

New opportunity with iHV – Research Associate BabyBreathe

Exciting and unique opportunity with the Institute of Health Visiting and the University of East Anglia on a National NIHR research study.

We are seeking an ambitious, enthusiastic Research Associate (RA) with experience in public health research to join the Institute of Health Visiting (iHV) for a fixed-term period of 12 months to support the delivery of the BabyBreathe NIHR Trial in the North-East of England site. The post is available from mid-February 2022 to cover the maternity leave of the current RA. The research is grant funded by the National Institute for Health Research (NIHR) working within the North-East of England. All work can be carried out remotely through home working, so the successful candidate can be based anywhere in the UK.

The Research Associate will be supporting a randomised trial of a postpartum relapse prevention intervention developed through an early phase intervention development study. The post holder will work as part of a team alongside Vicky Gilroy as the Principal Investigator for the North-East site from the iHV, supported by a team of experts in smoking cessation, and working with the trial manager as part of the Norwich Clinical Trials Unit as part of the University of East Anglia.

The individual would need to be dynamic, proactive, flexible and have the ability to work independently. They will be required to contribute to all elements of the research, this will include: helping to conduct literature reviews and evidence syntheses; supporting the development of study protocols and materials (e.g. interview topic guides and questionnaires); managing applications for ethical approvals; helping to deliver the training intervention; conducting data collection and analysis; contributing to research write up. Given the mixed-methods nature of the planned research, this post would suit someone with strong and demonstrable qualitative and quantitative research skills.

Key Requirements

Applicants should have a relevant master’s in a health or social science, and it is desirable to have completed or near-completed a PhD in Health Sciences/ Psychology/ Public Health related discipline.

The successful candidate must have experience of collecting and analysing qualitative and quantitative data. Excellent interpersonal skills, willingness and ability to work collaboratively and effectively as part of a team remotely and in person, in-depth knowledge of research design and methods relevant to applied health research, the potential to publish in high-quality journals, and excellent oral and written communication skills are essential.

This role does not meet the eligibility requirements for a tier 2 certificate of sponsorship under UK Visas and Immigration legislation. Therefore, the iHV will not be able to sponsor individuals who require the right to work in the UK to carry out this role.

Closing date: midnight Monday 17 January 2022, but the application may close early. Candidates are recommended to apply as soon as possible.

Interviews: Afternoon of Friday 21 January 2022 – please keep this date free.

For further details, job description and how to apply

Exciting opportunity with iHV – Research Associate – BabyBreathe

Exciting and unique development opportunity with the Institute

Research Associate – Based in North East England

Please note: short closing date due to start date of the study

We are seeking an ambitious, enthusiastic Research Associate, with experience in public health research to support the delivery of the BabyBreathe NIHR Trial in the Newcastle site, to join the Institute of Health Visiting (iHV) for fixed-term period of thirty-nine months. The post is available from October, following successful appointment. The research is grant funded by National Institute for Health Research (NIHR) working within the North East of England.

The Research Associate will be supporting a randomised trial of a postpartum relapse prevention intervention developed through an early phase intervention development study. The post holder will work as part of a team alongside Vicky Gilroy as the Principle Investigator for the Newcastle site from the iHV, supported by a team of experts in smoking cessation and working with the trial manager as part of the Norwich Clinical Trials Unit.

Key Requirements

Applicants should have a relevant master’s in health or social science, and it is desirable to have completed or near completed a PhD in Health Sciences/Psychology/Public Health/related discipline.

The successful candidate must have experience of collecting and analysing qualitative and quantitative data. Excellent interpersonal skills, willingness and ability to work collaboratively and effectively as part of a team remotely and in person, in-depth knowledge of research design and methods relevant to applied health research, the potential to publish in high quality journals and excellent oral and written communication skills are essential.

For further details, job description and how to apply

Applications close: anticipated to be midnight 23 September, but applications may close early due to the urgency in commencing this work. Candidates are recommended to apply as soon as possible.

Interviews: 2 October between 11:00 and 14:00 please keep that day clear in your diary.

For further information or an informal conversation about this post please contact Vicky Gilroy [email protected]