Objectives To adapt a tailored short message service (SMS) text message smoking cessation intervention (MiQuit) for use without active health professional endorsement in routine antenatal care settings, to estimate ‘real-world’ uptake and test the feasibility of its use.

Design Single-site service evaluation.

Setting A Nottinghamshire (UK) antenatal clinic.

Participants Pregnant women accessing the antenatal clinic (N=1750) over 6 months.

Intervention A single-sheet A5 leaflet provided in the women's maternity notes folder describing the MiQuit text service. Similar materials were left on clinic desks and noticeboards.

Outcome measures MiQuit activation requests and system interactions were logged for two time frames: 6 months (strict) and 8 months (extended). Local hospital data were used to estimate the denominator of pregnant smokers exposed to the materials.

Results During the strict and extended time frames, 13 and 25 activation requests were received, representing 3% (95% CI 2% to 5%) and 4% (95% CI 3% to 6%) of estimated smokers, respectively. Only 11 (44%) of the 25 requesting activation sent a correctly formatted initiation text. Of those activating MiQuit, and invited to complete tailoring questions (used to tailor support), 6 (67%) completed all 12 questions by text or website and 5 (56%) texted a quit date to the system. Of the 11 activating MiQuit, 5 (45%, 95% CI 21% to 72%) stopped the programme prematurely.

Conclusions A low-intensity, cheap cessation intervention promoted at very low cost, resulted in a small but potentially impactful uptake rate by pregnant smokers.