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Experts’ views on translating NHS support to stop smoking in pregnancy into a comprehensive digital intervention

McDaid, Lisa; Belderson, Pippa; Emery, Joanne; Coleman, Tim; Leonardi-Bee, Jo; Naughton, Felix

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Authors

Lisa McDaid

Pippa Belderson

Joanne Emery

TIM COLEMAN tim.coleman@nottingham.ac.uk
Professor of Primary Care

JO LEONARDI-BEE jo.leonardi-bee@nottingham.ac.uk
Professor of Evidence Synthesis

Felix Naughton



Contributors

Haleh Ayatollahi
Editor

Abstract

Many pregnant smokers need support to quit successfully. In the United Kingdom, trained smoking cessation advisors deliver structured behavioural counselling alongside access to free nicotine replacement therapy (NRT); known as the ‘Standard Treatment Programme’ (STP). Pregnant smokers who access STP support are more likely to quit, but uptake is low. A digital intervention could be offered as an adjunct or alternative to existing STP support to increase cessation rates. However, there are few pregnancy-specific digital options routinely available and, among those that are, there is limited evidence of their effectiveness. This study investigated experts’ views on the feasibility of translating the STP into a comprehensive digital intervention. Virtual group and individual interviews were undertaken with 37 experts (11 focus groups, 3 interviews) with a real-time voting activity in the focus groups to prompt discussion. Framework Analysis was applied to the data to examine themes and patterns. Experts were supportive of a digital translation of the STP and considered most behavioural counselling content to be transferable. However, replicating human-to-human accountability, empathy and the ability to go ‘off-script’ was thought more challenging. Suggestions for how this might be achieved included tailoring and personalisation, use of artificial intelligence tools, peer support and the option to escalate contact to a human advisor. Experts had mixed views on the role that exhaled breath carbon monoxide monitoring might have in a digital cessation intervention for pregnancy. Electronic provision of free NRT, and potentially e-cigarettes, without interpersonal support was generally well received. However, experts had concerns about it exacerbating low NRT adherence, governance issues (e.g. being accountable for the suitability of recommended products), and people’s ability to misrepresent their eligibility. The STP was considered largely transferable to a digital intervention and potentially helpful for cessation in pregnancy, so merits further development and evaluation.

Citation

McDaid, L., Belderson, P., Emery, J., Coleman, T., Leonardi-Bee, J., & Naughton, F. (2024). Experts’ views on translating NHS support to stop smoking in pregnancy into a comprehensive digital intervention. PLOS Digital Health, 3(3), Article e0000472. https://doi.org/10.1371/journal.pdig.0000472

Journal Article Type Article
Acceptance Date Feb 17, 2024
Online Publication Date Mar 27, 2024
Publication Date Mar 27, 2024
Deposit Date Mar 14, 2024
Publicly Available Date Apr 4, 2024
Journal PLOS Digital Health
Electronic ISSN 2767-3170
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 3
Issue 3
Article Number e0000472
DOI https://doi.org/10.1371/journal.pdig.0000472
Public URL https://nottingham-repository.worktribe.com/output/32464753
Publisher URL https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000472

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journal.pdig.0000472 (505 Kb)
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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
© 2024 McDaid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.





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