Uptake of Quitline Telephone Counselling by Women Who Smoke During Pregnancy

Background: While many pregnant women accept referrals for smoking cessation support, the uptake of telephone counselling appointments is unknown. Aims: To determine the uptake rate of Quitline appointments among Australian pregnant women who smoke after being referred by a healthcare provider. Materials and Methods: Data on attendance at telephone counselling appointments, number of appointments attended, gestational age at referral, referral source and smoking cessation upon completion of the program were requested from Quitline. Descriptive analysis of trends over time were undertaken using retrospective data from six Australian jurisdictions between 2016 and 2023 for pregnant women referred to Quitline by healthcare providers. Results: A total of 7503 pregnant women who smoke were referred to Quitline in the study period. More than half (n = 4072, 54%) did not attend any telephone counselling appointments, 24% (n = 1812) attended one appointment, 10% (n = 725) two, 5% (n = 359) three and only 7% (n = 535) attended four or more appointments. Gestational age at referral was available for 1203 women in Queensland, with 52% (n = 624) attending their first phone appointment between 1 and 20 weeks of pregnancy and 48% (n = 579) attending between 21 and 40 weeks. The overall referred smoking cessation rate in this cohort was 4% and 52% for those completing the program. Conclusions: The Quitline referral model for smoking cessation support for pregnant women is suboptimal. Comprehensive and consistent routinely collected data are urgently needed to monitor Quitline services for pregnant women who smoke across Australia. Further research is needed to understand the barriers to referral and uptake.