Background: Smoking is the biggest single threat to pregnancy, challenging the practice of midwives, the health and well-being of women and the development and survival of the child. One in three pregnancies are affected in New Zealand, two in three for Maori. This presentation describes the design, delivery and outcomes of a national education programme for midwives in facilitating smokefree change.

Strategy: Called Partners in Change the programme strives for competence in recognising cues, making on-the-spot assessments and seizing the motivational moment. Much is made of “using two minutes” and at every contact, to reinforce the evidence-based principle of “a little and often by many over time” for achieving large scale smokefree change. Course content is designed to align with familiar practice models (partnership) and prepare midwives to understand smoking, its effects on pregnancy, the process of change itself and then be able to recognise and work with its three phases of resistance, ambivalence and readiness. Between Jan 2001 and Dec 2006, 111 one day courses have been held, involving 1302 midwives with 1208 (93%) giving feedback. Participants rated the courses highly (93% as 7-9/9), 92% felt more confident and 58% have submitted case studies as evidence of their application of course principles to everyday practice. This presentation will report updated outcomes of impact on practice.

Conclusion: A carefully designed programme with a focus on how to support others to change has been highly acceptable to midwives and is suitable for any professional groups or behaviour requiring change.