Accessibility statement

Mothers learning about second-hand smoke (MLASS)

Exposure to second-hand smoke (SHS) during pregnancy and early infancy leads to low birth weight and childhood illnesses [1, 2]. 50% of all newborns in the UK are exposed to tobacco smoke due to maternal smoking or contact with SHS [3]. The evidence to support specific measures to implement smoking restrictions and reduce SHS exposure at home during pregnancy and the neonatal period is limited [4].

Our aim is to test the feasibility of delivering and evaluating the effectiveness of a Smoke Free Home (SFH) health education intervention with pregnant women and mothers with newborns to reduce unborn and newborn babies exposure to SHS.

The SFH intervention is designed to help women learn about the hazards of SHS, evaluate their own smoking behaviour, and empower them to negotiate smoking restrictions at home. The intervention will be delivered by midwives and health visitors during routine appointments at different points along the antenatal and postnatal care pathway.

We will measure salivary cotinine levels to assess the level of exposure to SHS in women who do not smoke during pregnancy. Urinary cotinine samples will also be collected in the newborns before and after the last delivery of the intervention.

A structured questionnaire will be used to assess the level of smoking restrictions at home.

Focus group discussions (FGD) with mothers who received the intervention will investigate their views on the appropriateness, acceptability and feasibility of the intervention in this setting. FGDs with health professionals and interviews with key health service managers will investigate the key constraints and drivers in the delivery & integration into routine practice for SFH.

[1] Windham GC, Eaton A, Hopkins B. Evidence for an association between environmental tobacco smoke exposure and birthweight: a meta-analysis and new data. Paediatric and Perinatal Epidemiology 1999; 13(10: 35-57.

[2] Cook DG, Strachan DP. Health effects of passive smoking: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax 1999 Apr 1;54(4):357-66.

[3] Ward C, Lewis S, Coleman T. Prevalence of maternal smoking and environmental tobacco smoke exposure during pregnancy and impact on birth weight: retrospective study using Millennium Cohort. BMC Public Health 2007; 7(1):81.

[4] Baxter S, Blank L, Everson-Hock ES, Burrows J, Messina J, GuillaUme L, Goyder E. The effectiveness of interventions to establish smoke-free homes in pregnancy and in the neonatal period: a systematic review. Health Education Research; 26 (2): 265-282.


Funder(s): Cancer Research UK 
Start Date: February 2013
Expiry Date: November 2014


Internal Staff

External collaborators

  • Amanda Amos
  • Gemma Mann
  • Samantha Middleton
  • Becky Reynolds 
  • Julie Scarfe 
  • Heather Thomson 

Public Health and Society Research in the Department of Health Sciences