Background: Starting Smokefree is a response to recommendations of a multi-disciplinary group of health leaders who met in October 2005 to provide professional leadership in addressing smoking in pregnancy. A presentation was made, by Education for Change to the Women's Health Managers group, of a managers resource package developed to support Christchurch Women's Hospital to achieve a ‘whole service' approach to smokefree pregnancies. The group was invited to express interest in extending this initiative to all women's health services and this was supported. The programme aims to align smokefree pregnancy systems, understanding and interventions and support a ‘whole service' approach to best practice.

Strategy: This presentation will describe the Starting Smokefree programme its design, implementation and progress to date. The main strategy is peer facilitation of a prepared presentation “Pregnancy Essentials” to accompany and strengthen the introduction of a smokefree pregnancy system/care pathway. The expectations are that maternity educators and smokefree co-ordinators work with women's health managers to introduce the programme. Within three months, 16 out of 21 DHBs (76%) were following up with this expectation, 11 had management commitment to the programme and 6 had signed User Agreements. One DHB has already completed the minimum 5 peer education sessions using the ‘Pregnancy Essentials' presentation.

Conclusion: Starting Smokefree brings together education and systems to provide a solid base from which to co-ordinate smokefree pregnancy leadership. While individual DHBs will progress at different rates, Education for Change will continue to support them at each stage.