Meet The TDT Team: Lisa Adams – Tobacco Dependency Champion Midwife
In September 2022, we launched our Tobacco Dependency Treatment (TDT) programme across all of our hospitals. This involves the screening of all patients admitted for tobacco addiction, providing personalised support to quit smoking for all those who opt in for treatment.
TDT has already seen some fantastic initial successes – with over 240 referrals made at Royal Derby Hospital and Queen’s Hospital Burton in the first two months of the campaign – and we remain committed to supporting those who make the decision to give up smoking under our care, however we can.
As part of this initiative, we have Tobacco Dependency Advisors across the Trust, who patients will speak to should they choose to opt-in to TDT following their initial tobacco dependency screening. This includes our Midwifery services – where pregnant people and their partners supported by one of our Tobacco Dependency Champion Midwives.
As part of our ‘Meet the TDT Team’ series, we’ve spoken to Midwife Lisa Adams, who is part of the TDT team at Royal Derby Hospital. Lisa has shared what her role involves, why quitting smoking is vital to the health of parents and their babies during pregnancy, and how even partners of pregnant people who smoke can have an impact on the baby’s health and development.
Lisa explained how TDT is implemented in maternity services: “We’ve always had some kind of tobacco dependency support pathway in our maternity services, however with TDT, we’re going one step further - making sure that all maternity colleagues work together and raise the issue of smoking during pregnancy as much as possible, even beyond that initial screening.
“Screening all inpatients in our services is new, but it’s in addition to existing pathways in providing the best possible care to our community when someone is going through pregnancy.
“As the Tobacco Dependency Champion Midwife, I’m here to ensure that our colleagues raise awareness of the harms of tobacco dependency, throughout their journey.”
It is not just the pregnant person themselves who can affect the health of an unborn baby. Lisa explained: “Often pregnant people and their partners don’t always appreciate the level of influence that tobacco addiction can have on their baby, and we’re here to give them the full facts, and offer both the pregnant person and their partners the support they need to quit.
“The partner of the pregnant person smoking can affect the pregnancy almost to the same levels as the pregnant person themselves through second-hand smoke. We use carbon monoxide monitoring during the pregnancy, and one of the new changes TDT has brought about is measuring this at every antenatal appointment, and this can also be picked up through second-hand smoke.
“There are a number of well-documented risks to a baby’s health through second hand smoke – particularly safe sleep after the baby has arrived with us.”
Lisa said that stopping smoking is one of the best ways to support healthy development of a baby during pregnancy: “Tobacco addiction affects a baby’s health right from the beginning. Tobacco smoke contains over 4,000 chemicals, 69 of which we know cause cancer.
“Taking all of this into your body as a pregnant person can affect the placenta and baby’s development during the first stage of pregnancy, and carbon monoxide – which has the most effect – latches onto the blood where oxygen normally travels, which stops the amount of oxygen the baby should receive and they tend not to grow as they should.
“We may assume that everybody knows these risks, but in recent years, with smoking prevalence decreasing more widely, I’m not sure that everyone is aware and that’s where I, and the TDT programme come in, to try to inform people of the risks involved with smoking during pregnancy and offer the support they need.”
Many smokers, pregnant or otherwise, may not feel they have the support they need to quit, even if they wanted to – but by screening all inpatients to our hospital sites as well as all pregnant people who access our maternity services, we can show them that there are many ways in which we can support them, through understanding their personal level of addiction.
Lisa agreed: “Tobacco dependency is an addiction. On our booking forms, smoking comes under ‘lifestyle choices’ – and it’s important for us to recognise that while it may have been a choice initially, once they smoke regularly, it is an addiction that is not as easy to quit as non-smokers might think. However, it is much easier with the help of our experts giving them the tools they need.
“For my role, pregnant people are already going through a range of lifestyle changes as a result of their pregnancy, and while there is never a bad time to quit smoking, this is one of the best opportunities for them to do so – improving their health, that of their baby, and of those around them.”