Government needs bold ambition on smoking in pregnancy to end inequalities

Friday 16 October 2015

A report published today by the Smoking in Pregnancy Challenge Group [1] calls on Government to close the gap in smoking in pregnancy rates between rich and poor. In a new review health organisations praise progress over the last few years in bringing rates down overall but argue much more must be done to tackle huge inequalities across the country. The report sets out recommendations for how a new Government strategy could nearly halve the current rate of smoking in pregnancy over the next five years [2].

In over 70,000 pregnancies a year women smoke. Too often women do not understand that smoking increases the risk of stillbirth and a baby being born underdeveloped and in poor health. It is estimated that smoking during pregnancy causes around 2,200 premature births, 5,000 miscarriages and 300 stillbirths every year in the UK. [3]

Earlier this year the rate of smoking in pregnancy fell below the Government ambition of 11% for the first time. This is down from over 13% in 2011/12 [4]. However, the England average conceals wide variations between areas with poorer communities hit hardest. In Westminster 2.1% of women were still smoking by the time their baby was born compared with 27.2% in Blackpool. Many areas with high rates of smoking in pregnancy, including Blackpool, have invested to bring rates down but action is needed across the system if sustainable change is to be achieved.

Worryingly Government statistics also show that some areas may still be failing even to ask pregnant women if they smoke. Some parts of the country had no data on the smoking status for more than half of pregnancies.

Francine Bates, Chief Executive, The Lullaby Trust said:

“Recent progress is great news but there is still much work to be done. Smoking in pregnancy remains the largest modifiable risk factor in sudden infant deaths, which devastates families. It is the most vulnerable who will be hit hardest if we do not do more to dramatically reduce the rates of smoking in pregnancy.”

Deborah Arnott, Chief Executive, Action on Smoking & Health, said:

“We know that local services to help support pregnant women quit smoking are under threat and the in-year cuts to the public health budget will only make this worse. The Government must maintain a strong commitment to tackling smoking among pregnant women. Local councils, national government and the NHS must work together if we’re to see an end to smoking in pregnancy.”

Linda Bauld, Professor of Health Policy at the University of Stirling and UK Centre for Tobacco and Alcohol Studies said:

“Although the Government is on track to meet its current ambition, progress must not stop there –it is not good enough that women in poorer parts of the country are 20 times more likely to smoke through their pregnancy than those in richer areas. If we’re to halve the rate of smoking in pregnancy over the next five years we need action in every community.”


Notes and Links:

[1] The Smoking in Pregnancy Challenge Group was established in 2012 to examine new ways of tackling the problem. In the coming months, the Challenge Group will publish a review of progress and recommendations for further action to help inform the Governments future work in this area. The Challenge Group members:

• Action on Smoking and Health
• Bliss
• Community Practitioners and Health Visitors Association
• Faculty of Public Health
• Family Nurse Partnership
• Fresh
• Institute of Health Visiting
• National Centre for Smoking Cessation & Training
• Public Health Action
• Royal College of Midwives
• Royal College of Nursing
• Royal College of Paediatrics and Child Health
• Royal College of Obstetricians and Gynaecologists
• Royal Society for Public Health
• Sands – Stillbirth and neonatal death charity
• The Lullaby Trust
• Tobacco Control Collaborating Centre
• Tobacco Free Futures
• Tommy’s
• UK Centre for Tobacco & Alcohol Studies

[2] The full recommendations are published here . The seven top line recommendations are:
1. A new national ambition to reduce smoking in pregnancy to less than 6% by 2020 to be included in the new tobacco plan;

2. National leadership to provide clarity about the roles local authorities and local NHS organisations and others should play in tackling smoking in pregnancy;

3. A robust and consistent national data collection system implemented across the country, with all pregnant women CO screened at the booking appointment and this recorded to identify smokers and/or those at risk from CO exposure;

4. Training of professionals to tackle smoking in pregnancy must be nationally mandated;

5. Opt-out referral of all pregnant women who smoke to specialist services must become standard practice across the country

6. Public Health England and NHS England should publish a shared national communications strategy on tackling smoking among pregnant women and their families

7. Research funders should continue to support high quality studies to help inform policy and practice on the best ways to help women to stop smoking in pregnancy.

[3] Royal College of Physicians, Passive Smoking and Children, 2010

[4] HSCIC, SATOD (Smoking Status at Time of Delivery)