Smoking in Pregnancy – an integrated model, incorporating self management and self esteem
Leena Sankla and Dr Kathy Hawley
Leena Sankla Project Director, Solutions 4 Health, Reading
Smoking in pregnancy increases infant mortality by about 40% and is much higher in routine and manual groups. Many women ‘spontaneously quit’ on discovering their pregnancy, or in the period of ‘trying’ before a pregnancy – although the relapse rate post-partum is still relatively high. Women who do not spontaneously quit are likely to be apparently less motivated (although this could be a low sense of self-efficacy in disguise) and/or more addicted to nicotine and smoking related ritual and behaviours.
These factors combine to make intervention with pregnant smokers more difficult and the need for behaviour change models more essential. Their fears around the consequences of smoking and being perceived as a ‘bad mother’ mean that – even more than any other – this group of women need sensitive handling.
In order to increase the overall success rates and wellbeing, a new integrated model has been developed. This is currently being piloted in Wirral and in essence combines the basis of stop smoking and self-management techniques, with an assessment of self -esteem before and after the programme.
Leena Sankla is a Public Health consultant and has overall responsibility for a number smoking cessation and chronic disease self-management projects, being rolled out across England that are commissioned by PCT’s. Her particular expertise is in reaching hard to reach groups, specifically Black Minority & Ethnic (BME) groups, socially deprived groups and routine and manual workers. She has a long-standing knowledge of smoking and tobacco control, including shisha use and tobacco chewing and delivers these courses to healthcare professionals.
She has worked closely with Tata Memorial Hospital, Mumbai and is a Master Trainer on Chronic Disease Self Management & Diabetes Self Management from Stanford University.
Dr Kathy Hawley, is the author of the Staying Positive Programme ( http://www.guardian.co.uk/winners-report/common-ground). Kathy has a Doctorate and technical qualifications in research and evaluation. She cut her teeth in self management as a senior trainer for Oxon, Bucks and Berks when the DH ran EPP. She currently works with a number of Universities on research/evaluation into self management.