Extra support is now available to help pregnant women quit smoking. Health Correspondent Barry Nelson meets one mum who succeeded.

UNLIKE many of the North-East's mums-to-be, smoker Sam Gillespie decided to quit her habit as soon as she found out she was pregnant. "I'd been thinking about stopping smoking anyway but when they told me I was definitely pregnant I thought, that's it, the fags have got to go," says Sam, 25, who runs the Grand Hotel pub in Bishop Auckland with her husband, Simon.

But actually quitting is never easy and it was a nurse at her doctor's surgery who suggested that Sam should make an appointment with Beverley Marr, a specialist smoking cessation support worker who has helped hundreds of County Durham women quit during pregnancy.

Beverley, who runs her personalised service across Sedgefield, Durham Dales and Darlington Primary Care Trusts, is a woman with a mission to do everything she can to help women to stop smoking, and stay stopped, during and after pregnancy.

Crucially, Beverley, a former midwife, provides one-to-one counselling for individual woman as they try to shake off nicotine's grip.

While women who sign up to the courses are encouraged to rely on willpower and the support of others to give up, around half have to have some form of nicotine replacement therapy, usually patches. Because of their condition, the women are only issued with patches which release nicotine into the bloodstream for 16 hours rather than the normal 24-hour patches.

Experts across the board agree that smoking during pregnancy increases the risks of a host of health problems for the foetus, ranging from growth retardation to stillbirth, quite apart from the increased risk of heart and circulatory disease and lung cancer for the mother.

Getting pregnant women to give up smoking is one of the highest priorities of the North-East smoking cessation service, which has some of the best results in the UK.

Since the service for pregnant women was established across large parts of southern and western Durham two years ago, Beverley has seen more than 600 pregnant women and their partners referred by their GPs or other health services for specialist support.

While she has a very high success rate - almost two-thirds of her clients - not everyone stays with the programme and Beverley estimates that 500 have actually signed up for smoking cessation support in the last two years.

Sam was determined to do all she could to protect the health of her new baby and quickly made an appointment to see Beverley. At the very first meeting the mum-to-be was asked to breathe into a device which measures carbon monoxide levels in the lungs, a sure sign of a regular smoker. What the test revealed made Sam even more determined to quit.

"I was absolutely staggered when I saw how high my carbon monoxide levels were," says Sam, who immediately enrolled in a structured course designed to support newly pregnant women who want to give up smoking.

Pretty soon after Sam gave up smoking, she had her carbon monoxide ratings checked again and was delighted to see that her score was back to normal.

"I was thrilled at how quickly the levels reduced to normal after stopping smoking and I knew then that I was determined to prevent any harm to my baby," says Sam.

"She tried to give up smoking before but she didn't manage it," says husband Simon, 40, who admits to having had the occasional cigar in the past. I have to say that she's been as good as gold.".

To try to cut down his wife's exposure to smoky air, Simon arranged to have a powerful ventilator installed at the front of the bar area. This means that bar staff working at the popular local rock music venue are also protected from the smoky atmosphere.

After successfully staying off cigarettes throughout her pregnancy, Sam gave birth to her baby daughter, Kylah Ann, on September 27. "She's wonderful, we are thrilled to bits, " says Sam, cuddling her new baby.

When she came into the new post two years ago, Beverley was thrilled at the prospect of helping pregnant women give up. With a background in midwifery, she knows only too well the battles that some women have in trying to give up the weed for their own sakes and the sake of their unborn children. A bonus is that she can often help the woman's partner to give up at the same time. "In Sam's case it was great that her husband was able to help her keep out of a smoky atmosphere by installing a ventilator," she says.

The case for not smoking during pregnancy is very powerful, which means that women are often battling guilt as well as the addictive effects of nicotine. "We have found that pregnant women seeking smoking cessation support prefer not to be seen in groups," says Beverley.

Depending on circumstances, Beverley provides individual support for four to 12 weeks. "I often have to make extra interventions in the first week, which is usually the most difficult time for smokers trying to give up," says Beverley, who does a lot of home visits to encourage people to stay on the smoking cessation wagon.

"I give the women two numbers so they can get hold of me if they need me urgently. Clients can also text me," says Beverley, who operates in Newton Aycliffe, Spennymoor, The Trimdons, Ferryhill, Bishop Auckland, Crook, Willington and Darlington.

Beverley says there is lots of evidence to suggest that giving up smoking in pregnancy has "enormous benefits" for both mother and baby.

"It certainly reduces the risks of miscarriage, stillbirth, cot death, premature labour, bleeding during pregnancy, intra-uterine growth retardation and much more," she adds.

Her job is made easier by the support of partners. "Dads and family members of pregnant women often want to support them by giving up smoking too. Pregnant women find it much easier to quit smoking and stay stopped if their partner and family quit too," she adds.

In many cases, families decide to declare their homes smoke-free zones to help the mum-to-be give up, but there is also the long term health benefit of giving up smoking to consider.

"Parenting is a demanding job. You need to be in peak condition and you want to be there for your children," says Beverley. "People who smoke have higher rates of illness and more serious health problems than non-smokers. If you stop smoking now, you will be able to take care of your children when they need you."

* If you need more information about giving up smoking ring the NHS Quitline on 0800 002200 or ask your doctor to refer you to your local smoking cessation service.