Background: Many women who become smokefree during pregnancy resume smoking after their baby is born, with relapse rates of 80% reported. Unlike most people who have had months of abstinence from smoking, pregnant women seem unlikely to maintain their change. Evidence from studies of this phenomenon suggest that both general and pregnancy-specific motivation are important for sustained smokefree change. The health gains to be had from success with such an approach are enormous for mother and child.

Strategy: The Smokechange programme has been successful in achieving sustained smokefree change for pregnant women. For 766 women, pregnant and smoking at enrolment, 273 (36%) reported being smokefree (>7days) after 6 months of Smokechange support and 215 (79%) of these were no longer pregnant at this assessment point. This presentation will demonstrate how the Smokechange programme works to link people to an awareness of their sources of intrinsic motivation. It will use case study methodology to describe how strategic questioning and reflection, and the use of visual tools (a river) come together to create opportunities for people to discover what really is important to them and how smoking is in conflict with their deeply held values and beliefs. The example will be reflections on working with a pregnant woman, presenting at enrolment as having multiple barriers to becoming smokefree yet confidently smokefree after six months of Smokechange support.

Conclusion: The importance of assisting pregnant women to tap into intrinsic resources for considering, making and maintaining smokefree change cannot be over-emphasised.