Government achieves smoking in pregnancy reduction target – but progress threatened by NHS cuts
New figures show that fewer women in England are smoking during pregnancy than ever before, with 6.1% recorded as smokers in 2024/25.[1] This means that the government has achieved the national target of 6% or fewer women smoking during pregnancy – although three years later than the 2022 target.
Smoking during pregnancy is a leading cause of poor birth outcomes including stillbirth, miscarriage and birth defects.[2] Supporting more pregnant women to quit smoking is a core priority for maternity services.
Rates of maternal smoking (SATOD) have declined rapidly since the introduction of dedicated stop smoking advisers in NHS maternity services in 2020.
However, a coalition of baby charities is warning that these services are threatened by recently announced cuts to NHS Integrated Care Board (ICB) budgets. ICBs – the organisations responsible for commissioning NHS services – have been asked to cut their running costs by 50% as part of a wider NHS reorganisation. Stop smoking support in some hospitals and mental health services has already been cut and further cuts are expected.
The Smoking in Pregnancy Challenge Group is calling on the government to protect funding for lifesaving quit support in maternity services and other NHS settings. They also want to see the government publish a new tobacco control strategy with refreshed targets for reducing smoking during pregnancy and tackling health inequalities.
Professor Linda Bauld, Bruce and John Usher Chair in Public Health at the University of Edinburgh and Co-Chair of the Smoking in Pregnancy Challenge Group said:
“The evidence is clear that stop smoking support for pregnant women has played a vital role in reducing rates of maternal smoking and saving babies’ lives. Without continued investment in these services there is a real risk that this decline could stall, or even start to reverse, with tragic consequences for parents and families.”
Dr Clea Harmer, Chief Executive of Sands and Co-Chair of the Smoking in Pregnancy Challenge Group, said:
“Reaching this milestone is a win but it’s not mission accomplished. As the government sets its sights on a smokefree generation, now is not the time to be cutting investment in these services. Instead, they should be going further and faster to ensure every child has a smokefree start in life.”
John Waldron, Policy and Public Affairs Manager at Action on Smoking and Health said:
“The progress made in reducing maternal smoking rates should be welcomed. However, many women who quit during pregnancy will be returning to households and communities where smoking remains common, increasing the likelihood they will relapse to smoking and putting them and their babies at risk of exposure to harmful secondhand smoke. A national strategy is urgently needed to set out how the government intends help people in the most deprived areas quit smoking for good."
Alizée Froguel, Cancer Research UK’s prevention policy manager, said:
“Smoking is the leading cause of cancer in the UK, responsible for around 160 new cases every day. For some people, including those who are pregnant and children, tobacco comes with more health risks and complications.
"While progress has been made to reach the smoking in pregnancy target, this is years later than expected. We can’t afford to be complacent in the fight against tobacco.
“The Tobacco and Vapes Bill is a historic opportunity to create a future free from the harms of tobacco, and it’s vital that it is accompanied by sufficient support to help everyone quit smoking. As our health services evolve and budgets are squeezed, tackling smoking must remain a key priority.”
Caitlin Notley, Professor of Addiction Sciences form the University of East Anglia said:
“The progress on reduced rates of smoking during pregnancy is fantastic, as translates to lives saved for both parents and babies through avoidance of exposure to harmful tobacco smoke. However, there are marked health inequalities, with smoking rates remaining above the national target amongst those living in some deprived areas in England. Relapse to smoking in the postpartum period also remains common. In a recent trial our team found that 50% of pregnant people who quit smoking while pregnant sadly relapsed in the 12 months after their baby was born. As well as continuing to support pregnant women to stay smokefree, we must invest in services that offer extended support, particularly for the most vulnerable families, for both quitting and sustaining smoking abstinence postpartum.”
Becca Scott, Smoke Free Pregnancies Lead, North East and North Cumbria NHS Integrated Care Board, said:
“Reducing tobacco dependency in pregnancy is one of the most important ways we can improve outcomes for both babies and mothers.
“This is a testament to the dedication of our Maternity and Health Visitor teams, Tobacco Dependency Treatment Services and the women themselves — who have made courageous and positive choices.
“Through personalised, supportive interventions at the point of care, we’re seeing real cultural change. We know there's still more to do, but this momentum shows what's possible when we work together with a shared vision for healthier pregnancies and healthier futures.”
Dr Andy McEwen, Chief Executive of the National Centre for Smoking Cessation and Training (NCSCT) said:
“Maternity services and their dedicated staff deserve congratulations for reducing maternal smoking rates, as does the government for its continued support for the National Smoke-free Pregnancy Incentives Scheme. To make sure that the quit rates at birth are maintained once women return to communities where smoking often remains prevalent, for the sake of both mum and child, more action is needed. A national strategy is needed to define how the government intends help people living in the most deprived areas of the country to stop smoking for good."
Dr Sarah McNulty, Director of Public Health for Knowsley and Lead Director for Smoke Free Cheshire and Merseyside said:
“Our vision is for every baby to be born smokefree, and to support families to stay smokefree into the first 12 months of babies’ lives and beyond, harnessing the historic opportunity created by the Tobacco and Vapes Bill.
“It is great to see rates of smoking in pregnancy coming down across Cheshire and Merseyside, closing the gap between some of our most deprived communities and the national figures.
“This success follows our commitment to implement an evidence based, more intensive model of support for smokefree pregnancies delivered within maternity services. This is now in place across the Cheshire and Merseyside Maternity System and is delivering results for families as part of our All Together Smoke Free programme which aims to end smoking, everywhere, for everyone.”
Jane Coyne, Assistant Director - Population Health, Treating Tobacco Depdendency Lead, NHS Greater Manchester said:
"We’re proud to have played a leading role in reducing smoking in pregnancy through dedicated support in maternity services, innovative incentive schemes, and strong public health partnerships. Our work has helped improve outcomes locally and informed national approaches, including the NHS 10-Year Plan. Tackling smoking in pregnancy is also crucial to reducing health inequalities that begin before birth and persist throughout life. Continued investment is essential to protect these hard-won gains and support more families to have healthier pregnancies.”
Notes to the Editor
For interviews contact press@ash.org.uk
The Smoking in Pregnancy Challenge Group is a coalition of organisations committed to reducing rates of smoking in pregnancy. The Group is a partnership between the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health, the voluntary sector and academia. The Group is jointly chaired by Dr. Clea Harmer, Chief Executive of Sands, and Professor Linda Bauld, Bruce and John Usher Chair in Public Health at the University of Edinburgh.
References
[1] NHS Digital. Statistics on Women's Smoking Status at Time of Delivery: England, Q4 2024/25. 19 Jun 2025
[2] Impact of smoking and exposure to secondhand smoke during pregnancy
| Maternal Smoking | Secondhand Smoke Exposure | |
| Low birth weight | 2 times more likely | Average 30-40g lighter |
| Heart Defects | 25% more likely | Increased risk |
| Stillbirth | 47% more likely | Possible increase |
| Preterm birth | 27% more likely | Possible increase |
| Miscarriage | 32% more likely | Increased risk |
| Sudden Infant Death | 3 times more likely | 45% more likely |
Source: Zhao L et al. Parental smoking and the risk of congenital heart defects in offspring: An updated meta-analysis of observational studies. 2020; RCP. Hiding in plain sight: treating tobacco dependency in the NHS. 2018; Pineless BL et al. Systematic review and meta-analysis of miscarriage and maternal exposure to tobacco smoke during pregnancy. 2014; RCP & RCPCH. Passive Smoking and Children. 2010