Unprecedented progress in tackling smoking during pregnancy threatened by NHS cuts, experts warn

A coalition of baby charities is warning that unprecedented progress in reducing the number of women smoking during pregnancy in England is being put at risk by NHS funding cuts.

According to an article in the British Medical Journal, the proportion of women smoking during pregnancy in England has almost halved from 11.7% in 2014/15 to 5.9% as of Q3 2024/25 – with most of the decline happening in the last 5 years. The authors attribute this ‘public health success story’ to the introduction of dedicated stop smoking advisers in NHS maternity services since 2020 and call for continued investment to give every child a smokefree start in life.

However, these services are threatened by recently announced cuts to NHS integrated care board budgets and the loss of ringfenced funding for NHS tobacco treatment services.

The Smoking in Pregnancy Challenge Group is warning that there is a real risk ICBs will begin scaling back these services as part of cost cutting exercises. Stop smoking support in some hospitals and mental health services has already been cut and further cuts are expected.

Professor Linda Bauld, Co-Chair of the Smoking in Pregnancy Challenge Group and co-author of the BMJ article 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: “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.”

Professor Caitlin Notley, Professor of Addiction Sciences at the University of East Anglia and co-author of the BMJ article said: “The progress on reducing rates of smoking in pregnancy has accelerated in recent years, thanks to the focused efforts of all healthcare professionals involved in the pregnancy care pathway. However, there remain significant inequalities, as rates of smoking remain higher in deprived areas, suggesting that we need innovative and targeted approaches for those who really struggle to quit.”

John Waldron, Policy and Public Affairs Manager at Action on Smoking and Health and co-author of the BMJ article said: “The 2024 Labour manifesto committed to ensuring that all hospitals integrate smoking cessation support into routine care. The government must deliver on this commitment by protecting funding for these lifesaving services.”

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.