Research Projects

MOHMQuit – Midwives and Obstetricians helping Mothers to Quit Smoking – implementation trial

Project Summary

Our researchers have teamed with partners in five local health districts across NSW to tackle smoking in pregnancy through the MOHMQuit trial. Smoking in pregnancy leads to many negative outcomes for the baby including increased risk of premature birth, being born sickly or stillborn and sudden infant death syndrome (SIDS). For the mother, smoking increases her risk of high blood pressure, heart disease and cancer. Stopping smoking reduces these preventable negative outcomes. Unfortunately, many midwives, doctors and other health care professionals find giving smoking cessation support in antenatal care difficult. MOHMQuit is an innovative program designed to improve support provided to pregnant smokers during antenatal care and lift quitting rates. The program uses a whole-of-system approach to strengthen smoking cessation leadership, address gaps in health system processes, and help clinicians to provide effective, evidence-based support to pregnant women.

Our Investigators

  • Professor Megan Passey
  • Dr Jo Longman
  • Dr Larisa Barnes
  • Professor Ross Bailie

Collaborators

  • Professor Christine Paul, University of Newcastle
  • Professor Billie Bonevski, Flinders University
  • Dr Lou Atkins, University College London
  • Professor Ross Bailie, University of Sydney
  • Dr Alison Pearce, University of Sydney
  • Dr Daniel Barker, University of Newcastle
  • Professor Andrew Milat, University of Sydney
  • Dr Aaron Cashmore, NSW Ministry of Health
  • Dr Catherine Adams, NSW Ministry of Health
  • Joanne Scarfe, University of Sydney
  • Kate Reakes, Cancer Institute NSW
  • Dr Laura Twyman, Cancer Council NSW
  • Jane Griffith, Illawarra Shoalhaven Local Health District
  • Madeline Hubbard, Western NSW Local Health District
  • Julie Dorling, Western NSW Local Health District
  • Sandra Forde, Murrumbidgee Local Health District
  • Dr Virginia Stulz, University of Canberra
  • Dr Dianne Avery, Western NSW Local Health District
  • Dr Michael Nicholl, Clinical Excellence Commission
  • Dr Rashna Chinoy, Illawarra Shoalhaven Local Health District
  • Dr Mohamed Foda, Murrumbidgee Local Health District
  • Megan Morris, NSW Ministry of Health
  • Justine Elliot, Nepean Blue Mountains Local Health District

Partner organisations

The MOHMQuit trial is funded by the National Health and Medical Research Council with support from the NSW Ministry of Health, the Cancer Council NSW, the Cancer Institute NSW, the Northern NSW LHD, Western NSW LHD, Murrumbidgee LHD, Illawarra Shoalhaven LHD and Nepean Blue Mountains LHD.

Status/timing

MOHMQuit was developed through a collaborative program of research, commencing in 2014. The implementation trial commenced in November 2020 and will continue until the end of 2025.

What does the Project focus on?

MOHMQuit focuses on helping maternity services to provide evidence-based, effective smoking cessation support during antenatal care, with the aim of helping women to quit smoking. Research for MOHMQuit started in 2014 with qualitative and quantitative studies with midwives and obstetricians to find the barriers and enablers they experience in providing smoking cessation support to pregnant mothers. Following collaborative development of MOHMQuit with health system partners and a feasibility study of the MOHMQuit program at one maternity service, we are now running a large trial in nine maternity services in NSW.

What type of project/study?

MOHMQuit is a cluster-randomised stepped-wedge implementation trial. This means that all trial sites (clusters) receive the MOHMQuit intervention in a stepped fashion, and that baseline and follow-up data is collected from all sites across the 32-month trial period. There is also a control site throughout the trial.

What do we expect to achieve with this project when complete

The MOHMQuit trial will provide real world evidence of the effectiveness and cost-effectiveness of the MOHMQuit program. This will inform policy and potentially allow for subsequent scaling-up. Additionally, it will advance our understanding of developing and implementing systems-change behavioural interventions by examining what worked, where and why, through a comprehensive process evaluation.

Unexpected direction?

When we started this project, very few people used vapes (e-cigarettes). However, the rapid escalation in their use, including by pregnant women, has raised serious health concerns. We have commenced additional research to better understand this phenomenon.