Background: A large number of intensive smoking cessation services for pregnant women smokers were funded from 1999/2000, however by 2005 only a few were delivering a comprehensive service. Objectives of the evaluation included an overview of current practice based on international literature and the New Zealand experience in order to identify the range of services required and best practice principles for services going forward

Method: A multi method evaluation was carried out over a two-year period. This included preliminary research with experts, a literature review on smoking in pregnancy, an overview of the New Zealand health sector support of pregnant women who smoke, and research with providers delivering intensive programmes to pregnant women who smoke.

Results: Services in New Zealand appear to be delivering a high standard of practice in what is a challenging area although service coverage across New Zealand is limited to discreet locations.

Conclusions: There is a wealth of knowledge and a highly skilled workforce among the few services who work with pregnant women who smoke. Both the international literature and the New Zealand experience shows that delivery of these services is particularly challenging and requires intensive training, support and ongoing commitment and support from a range of people in the sector.

Implications: A range of recommendations were presented to the Ministry and service providers. This included best practice principles for services and suggestions for a strategic framework to support service delivery. In future, with best practice principles in place impact evaluation of these important services is recommended.