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Press Release

Raise age of sale for tobacco to give every child a smokefree start in life say baby charities

12 Dec 2023

A coalition of baby charities has backed the Prime Minister Rishi Sunak’s plans to increase the age of sale for tobacco by one year, every year, from 2027. They estimate this could help reduce the number of women smoking during pregnancy by around 10,000 a year by 2033 and create a smokefree generation.

Smoking during pregnancy is concentrated in younger parents who will be an early group to benefit from increasing the age of sale. Maternal smoking is a leading cause of poor birth outcomes including stillbirth, miscarriage and birth defects and increases the risk of Sudden Infant Death Syndrome (SIDS). Women who are smoking at their first midwifery appointment can find it difficult to quit due to higher levels of addiction than those who quit before or in early pregnancy.

The Smoking in Pregnancy Challenge Group set out six high impact recommendations in its ‘manifesto for smokefree beginnings’ published today [12th December]. These include passing legislation to raise the age of sale and setting a new target to more-than halve rates of maternal smoking, from 8.8% now to 4% by 2030.

The manifesto will be launched at an event in Parliament today to celebrate the Challenge Group’s 10-year anniversary, hosted by the APPG on Smoking and Health and the APPG on Baby Loss. The event will also be an opportunity to celebrate the efforts of maternity professionals supporting women to have smokefree pregnancies.

One of these professionals is Anna Tye, a Healthy Pregnancy Support Worker working on the South Coast. Anna worked with a woman who lost babies in two successive pregnancies to conditions associated with smoking in pregnancy. She first met Anna in her second pregnancy where she engaged intermittently with stop smoking support and they developed a trusting relationship. When she became pregnant again for the third time, she contacted Anna immediately and asked for support to quit smoking. The woman engaged with Anna throughout her pregnancy and with Anna's support, education, and the help of financial incentives, managed to quit smoking and stay smokefree throughout her pregnancy. Her baby was born and went home to a smokefree home.

Anna is one of five professionals being recognised for their work at the anniversary event. She said: “I absolutely love the role that I have supporting pregnant women to quit smoking. It is so important to me that they feel supported to make a change that they often feel is too hard or too big a challenge. Giving women information, guidance and support in a way that is relatable helps them to realise they can make huge, long-term improvements to both theirs and their unborn baby’s life.”

Professor Linda Bauld, Director of the SPECTRUM Research Consortium and Co-Chair of the Smoking in Pregnancy Challenge Group said:

“Over the last decade, the Smoking in Pregnancy Challenge Group has worked tirelessly to ensure that women get the support they need to have a healthy pregnancy and a healthy baby.

“During this time, rates of smoking in pregnancy have fallen by around a third and we have seen clear commitments on maternal smoking from the NHS and Government. But there is more to do to ensure that every child has a smokefree start in life.”

"Reducing smoking among women before they become pregnant would not only spare many families from the heartbreak of losing their baby to stillbirth or miscarriage, but would also ease pressure on vital NHS services and put money spent on tobacco back in people’s pockets.”

Dr Clea Harmer, Co-Chair Smoking in Pregnancy Challenge Group and Chief Executive of Sands, said:

“A smokefree future for every child is now within reach thanks to the Prime Minister’s commitment to create a smokefree generation, but this future will only be realised if the Government delivers on what has already been announced and goes further.

“The recommendations made by the Challenge Group set out the action that is needed to set us on track for a future where all births are smokefree. Our hope is that politicians of all parties will rise to the challenge and there will be no need for us to repeat this report on our twentieth anniversary. Until then, the Challenge Group will continue to hold the Government to account and campaign for action to save babies’ lives.”

Public Health Minister Andrea Leadsom said:

“Smoking is the most important preventable risk factor in pregnancy, and it can lead to a range of awful outcomes, including miscarriage, stillbirth or even sudden infant death syndrome.

“That is one of the many reasons why we are pushing ahead at pace with our plans to create the first ever smokefree generation, which will save tens of thousands of lives and save the NHS billions of pounds.

“Parents and their partners will also be offered financial incentives to help them stop smoking. This will involve, by the end of next year, offering vouchers alongside behavioural support to all pregnant women and their partners who smoke.”


In the coming weeks, the government will publish the response to its public consultation and confirm the next steps it will take to ensure its proposals become law as quickly as possible.

Bob Blackman, Chairman of the APPG on Smoking and Health, said:

“I’m pleased to support the Challenge Group’s call to the Government to deliver on their commitment to raise the age of sale for tobacco by one year, every year, to create a smokefree generation and reduce the number of young mums smoking during pregnancy.

“We’ve seen the Government in New Zealand drop this world-leading policy, putting short term political considerations ahead of long-term savings and countless human lives.

“The Prime Minister has rightly rejected calls from the tobacco industry to follow New Zealand and has reiterated his commitment to creating the first smokefree generation. On this, he has the APPG on Smoking and Health’s full support.”

Gill Walton, Chief Executive of the Royal College of Midwives, said:

“Midwives and maternity support workers have such an important role in providing support and guidance to pregnant women wanting to give up smoking. There are already some great programmes running across the country, but we could do so much more and reach many more women if the right funding was in place. A sustained and sustainable approach is vital if we are to see an end to smoking in pregnancy.”

Notes to the editor

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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 of the SPECTRUM Research Consortium and the University of Edinburgh.

High impact recommendations from the Challenge Group’s manifesto for smokefree beginnings

  1. Pass legislation to raise the age of sale for tobacco by one year, every year, to reduce smoking prevalence in the age cohort most likely to smoke during pregnancy and create a smokefree generation.
  2. Introduce a ‘polluter pays’ levy on tobacco manufacturers to raise funding for the measures needed to deliver a smokefree start for every child.
  3. Fully implement the national financial incentive scheme and commit to extending the scheme beyond 2024.
  4. Set out a new target for reducing rates of Smoking Status at Time of Delivery (SATOD) to 4% by 2030, putting England on track to deliver a smokefree start for every child before 2040.
  5. Ensure NHS tobacco dependence treatment services for pregnant women are fully embedded and sustained long-term.
  6. Commit to develop and fund models of care to prevent relapse to smoking postnatally