Action on Smoking and Health

Tag Archives: pregnancy

Smoking, pregnancy and fertility

Smoking during pregnancy is the leading modifiable risk factor for poor birth outcomes, including stillbirth, miscarriage, and pre-term birth. Smoking during pregnancy also increases the risk of children developing
several respiratory conditions, attention and hyperactivity difficulties, learning difficulties, problems of the ear, nose and throat, obesity, and diabetes. December 2021.

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ASH Daily News for 7 September 2018


  • NHS smoking in pregnancy data shows 10.4% of pregnant mothers still smoke in England
  • Opinion: It’s time to stop tarring e-cigarettes and tobacco with the same brush
  • Don’t send vapers to use smoking shelters, MPs suggest
  • Prevention must be the heart of the NHS long-term plan


  • Most U.S. colleges are not tobacco and smokefree

Parliamentary Activity

  • Parliamentary Question

Link of the week

  • Keep Britain Tidy video


NHS smoking in pregnancy data shows 10.4% of pregnant mothers still smoke in England

New NHS figures have revealed the number of women who said they were smokers at the time of giving birth between April and June this year. The numbers relate to 147,770 births during this three-month period. In total 15,151 of those babies – 10.4% – were born to mothers who continued to smoke tobacco while they were pregnant.

Nationally there is a Government ambition to reduce the number of pregnant mothers smoking to 6% or less by 2022. However, only 33 out of 195 areas met this target in the first quarter of this year, and a tenth of women across England were smoking at the time of delivery.
Smoking during pregnancy has been proven to worsen babies’ health as they grow older and to increase the risk of a premature birth or cot death.

Vicky Salt, policy manager at Action on Smoking and Health, said:
“Smoking during pregnancy is a leading cause of still birth and miscarriage as well as premature birth and low birth weight. The data released today shows a welcome decline in women smoking during pregnancy. However, this is only across three months and while a few areas are already reaching the Government’s 6% target, many more are nowhere near. We must ensure fewer women are smoking when they become pregnant and that midwives are properly trained to help those who are smoking quit as soon as possible.”

Source: Daily Mail, 6 September 2018

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Opinion: It’s time to stop tarring e-cigarettes and tobacco with the same brush

Rt Hon Norman Lamb, chair of the Science and Technology Select Committee, writes about the relative harms of e-cigarettes compared with tobacco cigarettes.

“You might have seen some huffing and puffing over the Science and Technology Committee supposedly recommending that e-cigarettes should be allowed on public transport. Yesterday, I made a statement to the House of Commons about our recent report on e-cigarettes to clarify what we actually said. The evidence is clear: e-cigarettes are significantly less harmful to a smoker’s health than conventional cigarettes.

Public Health England estimates that e-cigarettes are around 95 per cent less harmful. They’re not the only ones — NICE, the British Medical Association, Cancer Research UK, the Royal Society for Public Health, and the Royal College of Physicians of Edinburgh are just some of the organisations that agree.

A growing number of people are turning to e-cigarettes as a useful tool to stop smoking. Yet many misconceptions about e-cigarettes persist, with some people demanding that e-cigarettes and tobacco cigarettes should be treated in the same way.”

Source: The Times, 7 September 2018

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Don’t send vapers to use smoking shelters, MPs suggest

About 2.9 million people in the UK are currently using e-cigarettes. On Thursday, MPs debated a report on e-cigarettes, by the science and technology select committee, which suggested that e-cigarettes were too often overlooked by the NHS as a tool to help people stop smoking.

Organisations should consider having a separate vaping room or area instead of vapers having to use smoking shelters. Putting vapers and smokers together had been likened to “an alcoholic being put in a pub situation and expected to refrain”, SNP MP Carol Monaghan said.

Ms Monaghan, a member of the committee, said that the evidence they heard suggested e-cigarette users were “having to go out and use smoking shelters outside buildings” and urged a “more realistic view of the use of e-cigarettes”.

Source: BBC News, 6 September 2018

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Prevention must be the heart of the NHS long-term plan

Chief executive of Public Health England, Duncan Selbie, has said he wants a “smoke-free society” by the year 2030. He told the NHS England Expo in Manchester: “Smoking should no longer be seen as a lifestyle choice. It is an addiction that warrants medical treatment. Everyone who smokes must be offered the support they need to quit. With the right long-term plan in place, we can remove smoking from England. This is the single biggest thing we can do to improve the nation’s health.”

He said the move would save thousands of lives and free up almost £900million a year; funds that the NHS currently spends on treating illnesses caused by tobacco.

See also: Public Health England: Prevention must be the heart of the NHS long-term plan

Source: The Sun, 7 September 2018

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Most U.S. colleges are not tobacco- and smokefree

Most U.S. universities and community colleges don’t have tobacco-free or smokefree policies on campus, a new study has found. About 35% have tobacco-free policies that prohibit all tobacco use, 10% have smokefree policies that prohibit cigarettes but not all tobacco and 54% don’t have any policy, researchers report in the American Journal of Public Health.

“Despite years of public health effort, only 59% of the U.S. population is covered by smoke-free non-hospitality workplace, restaurant and bar laws in 2018,” said senior study author Kelvin Choi, a researcher with the National Institute on Minority Health and Health Disparities in Bethesda, Maryland.

See also: American Public Health Association, Adoption of Tobacco- and Smoke-Free Policies in a US National Sample of Postsecondary Educational Institutions

Source: Reuters, 6 September 2018

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Parliamentary Activity

Parliamentary Question

Martyn Day Scottish National Party, Linlithgow and East Falkirk
To ask Mr Chancellor of the Exchequer, what steps he is taking to ensure that the UK tobacco product track and trace system will be compliant with the requirements of the (a) EU Tobacco Products Directive and (b) WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products; and if he will make an assessment of the potential merits of implementing a tax stamp, label-based track and trace system.

Robert Jenrick The Exchequer Secretary

The government published an invitation to tender for the issuing of unique identifiers for the tobacco product track and trace system on 31 August. It is a key condition of securing this contract that the system proposed meets all the requirements of both the EU Tobacco Products Directive and WHO FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products.

The government has no plans to introduce tax stamps for tobacco products. If a label-based track and trace system is proposed by any of the bidders for the contract, this will be assessed against the requirements for the system alongside any other bids made.

Source: Hansard, 6 September 2018

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Link of the week

Keep Britain Tidy video

Keep Britain Tidy have launched a new national campaign – #BinTheButt – to stamp out cigarette litter, which causes significant damage to marine life.

They’re calling on smokers across the UK to rethink how they dispose of their cigarettes, as research reveals that only half (53%) of Brits think that cigarette butts get washed into the sea if they get dropped, blown or washed down the drain.

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Smoking and Diabetes

There is a growing body of evidence to suggest that smoking is an independent risk factor for diabetes and that among people with diabetes, smoking aggravates the risk of serious disease and premature death. November 2017.

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Smokefree Skills: an assessment of maternity workforce training

This report provides an analysis of the training that midwives and obstetricians receive to address smoking in pregnant women, and what further training is needed. Smoking is a major cause of stillbirth and sudden infant death, and also leads to more babies being born with health problems and with a low birth weight.

You can read the full report here and the executive summary here.

Calls for work in North East to cut smoking in pregnancy to be rolled out nationwide

16 September 2016.  News Release on behalf of the Smoking in Pregnancy Challenge Group 

Work in the North East to cut smoking in pregnancy by nearly 1/3 has been hailed as an example for the rest of England to follow by a coalition of national health and baby charities.

Francine Bates, Chief Executive of the Lullaby Trust and Professor Linda Bauld who are Co-Chairs of the Smoking in Pregnancy Challenge Group, along with ASH which co-ordinates the group, praised the rapid fall in North East maternal smoking rates after a four year initiative to help midwives raise smoking as a crucial issue affecting unborn babies’ health.

Every woman in the North East is now routinely given carbon monoxide monitoring when they first see a midwife – and those with high readings referred to a stop smoking service, following the NICE guidance[i]. For those women still smoking at 12 weeks, a midwife leads a detailed discussion highlighting the potential harm to the unborn child – resulting in rates falling from 22.2% of women smoking at the time they gave birth in 2009-10 down to 15.6% in 2016.

Fresh – the North East’s tobacco control office funded by all 12 local authorities – has overseen the rollout of the “babyClear” approach[ii] which works in two ways:

  • Women receive carbon monoxide (CO) monitoring as part of the routine tests during their booking appointment at around 8 weeks into the pregnancy. All high CO readings are routinely referred to Stop Smoking Services within 24 hours where they can get help to quit.
  • Women still smoking at their 12 week dating scan are talked through a more hard hitting and factual discussion on the harms of smoking with their midwife, using software to show the potential harm being done when an unborn baby is exposed to smoke.

The Smoking in Pregnancy Challenge Group, including ASH, the Royal College of Midwives, Tommy’s and the Lullaby Trust, published a report[iii] in 2013 calling for more action to fully embed the NICE (National Institute for Health and Care Excellence) guidance around smoking in pregnancy and renewed the call for action in a review of progress in 2015.[iv] The Group recommends midwives raise smoking as an issue, use carbon monoxide monitoring to check high levels of exposure to tobacco smoke; and refer all smokers to local stop smoking services.

Deborah Arnott, chief executive of health charity ASH, which co-ordinates the Challenge Group, said:

“The North East has made great strides in reducing smoking in pregnancy by a combination of hard work and a well thought out, evidence-based approach. If the government is to meet its commitment to reduce the rate of stillbirths, neonatal and maternal deaths in England by 50% by 2030 all of England needs to follow their lead.”

Francine Bates, Chief Executive of The Lullaby Trust and Co-Chair of the Challenge Group said:

“The North East region is to be hugely congratulated for the work they are doing to support women to stop smoking in pregnancy.

“Maternal smoking is now the single biggest modifiable factor for sudden infant deaths. This programme will undoubtedly have saved many babies’ lives and greatly improved health outcomes for families previously exposed to second-hand smoke. I hope that other parts of the country will take note and implement a similar systematic approach.”

Professor Linda Bauld, Co-Chair of the Smoking in Pregnancy Challenge Group and Professor of Health Policy at the University of Stirling said:

“The North East of England has taken a lead in implementing evidence-based recommendations from NICE and the Smoking in Pregnancy Challenge group.

“The progress that has been achieved is impressive and provides a valuable example for other parts of the country. These changes have undoubtedly saved lives – not just for babies and infants but also for mothers, as pregnancy provides a unique opportunity for women to stop smoking and stay stopped over the longer term.

“The region have also evaluated their approach through independent research and I look forward to the publication of those results, which will provide invaluable evidence for us to continue to make the case for action that contributes to continued declines in smoking in pregnancy in the future.”

Ailsa Rutter, Director of Fresh, said:

“Most women who smoke will have started in their teens or younger, and we recognise it is an addiction that is not always easy to quit. Women need the facts but also to know there is excellent free support to quit smoking where they will be supported and helped, not have the finger wagged at them.

“Some women can find the facts quite shocking – but most are very glad they have been told and come to expect this as part of their ante-natal care.”

Peter Kelly, North East Public Health England Centre Director, said: “Supporting women in having a healthy pregnancy is essential for their health and their unborn child.  Stopping smoking is a critical element of a healthy pregnancy and it is very encouraging to see such progress in the North East.”

Following babyClear’s launch in 2012, around 450 midwifery staff and 150 Stop Smoking Service advisers have received skills training to discuss the issues with women in a factual, blame-free way, as well as being provided with equipment to deliver interventions.

When a smoker inhales, the 5000 chemicals in smoke, such as arsenic, benzene and formaldehyde, are absorbed through the lungs and move into the bloodstream. In pregnant women, these chemicals are passed to the unborn baby, depriving them of vital oxygen. Exposure to CO may cause harm to an unborn child, including low birth weight, perinatal death (stillborn and deaths within the first four weeks of birth), and behavioural problems.

A report by the Royal College of Physicians published in 2010 (Passive smoking and children) found maternal smoking causes up to 5,000 miscarriages, 300 perinatal deaths (stillbirths and sudden infant deaths within the first four weeks of birth) and 2,200 premature births a year nationwide. In the North East that breaks down to 360 miscarriages, 22 perinatal deaths (stillbirths and sudden infant deaths with the first four weeks of birth) and 160 premature births.

Research with midwives by NHS North East and Newcastle University in 2010 found not all midwives felt confident or equipped to raise smoking during pregnancy, with many wanting more training and resources such as CO monitors. Feedback from wards has also found women come to expect smoking being raised as an issue, and does not affect the positive relationship they have with their midwife.

Figures published in August 2016 revealed the North East has also seen the biggest fall in overall adult smoking rates in England since 2005, from around 29% of people smoking down to 18.7% in 2015.



[i] NICE guideline PH48 – Smoking: acute, maternity and mental health, and NICE guideline PH26 – Smoking: stopping in pregnancy and after childbirth

[ii] babyClear – an intervention developed by the Tobacco Control Collaborating Centre

[iii] Smoking Cessation in Pregnancy – a Call to Action


The Smoking in Pregnancy Challenge Group, which includes the Royal College of Midwives (RCM), Royal College of Paediatrics and Child Health (RCPCH), the third sector and academia, was established in 2012 in response to a request by the Rt Hon Anne Milton MP, the then Public Health Minister.

The challenge to the Group was to produce recommendations for accelerating progress towards the Government ambition of reducing the rate of smoking at the time of delivery to 11% or less by 2015.

In June 2013 the Group produced recommendations on how the Government ambition for reduced rates of smoking in pregnancy could be achieved.   (Smoking Cessation in Pregnancy – A Review of the Challenge)

The Group continues to collaborate to and in 2015 published a review of progress and updated recommendations. More information about the Challenge Group is available on the Groups webpage.

Charities call for Government action to maintain progress on smoking in pregnancy rates

Thursday 16 June 2016

The Smoking in Pregnancy Challenge Group [1], a coalition of health and baby charities, today welcomed the news that smoking rates among pregnant women have continued to fall but warned that progress could be jeopardised if services to help people quit continue to be cut around the country.


Smoking at Time of Delivery data [2], published by the Government today, shows that 10.6% of women were smoking at the end of their pregnancy in 2015/16 compared to 11.4% in 2014/15.  This means the Government has met its ambition to reduce smoking rates among pregnant women to less than 11% by 2015.  However, these figures hide the variation between different parts of the country. Areas where smoking rates and deprivation are high have rates many times that of more affluent areas.


In many places local authorities and local maternity services have been working hard to encourage more pregnant women to quit. However, cuts to the public health budget  nationally means there are fewer resources available locally to fund vital quit smoking support which can improve a person’s chances of quitting by up to four times.


Reducing rates of smoking in pregnancy has been an important Government priority with ambitions in the last Tobacco Control Plan for England [3]. It is also key to achieving other priorities such as the Government’s commitment to halve the number of still born babies [4]. The Smoking in Pregnancy Challenge Group have called on Government to include strong new ambitions in the forthcoming new Tobacco Control Plan and to end the difference in rates between rich and poor areas [5].


Professor Linda Bauld, Professor of Health Policy at University of Stirling and Co-Chair of the Smoking in Pregnancy Challenge Group said:


“We must invest in a full range of measures or smoking in pregnancy rates will start to rise. This cannot be done in a piecemeal way – we must ensure that fewer women are smoking when they become pregnant, more women are encouraged to quit quickly and greater support is offered to those who need it.”


Francine Bates, Chief Executive of The Lullaby Trust and Co-Chair of the Smoking in Pregnancy Challenge Group said:


“Higher smoking rates among poorer pregnant women is a major cause of inequality. Investment in services to support women to quit is needed by every local authority. If we do not support women to quit when they become pregnant we are locking in a lifetime of inequality.”


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


“There has been significant progress in reducing the numbers of women smoking during pregnancy. The new Tobacco Control Plan should set an ambitious vision for reducing rates further and clearly identify how this can be achieved.”



[1] The Smoking in Pregnancy Challenge Group was set up in 2012 following a challenge from the then Public Health Minister. It is coalition of organisations and is co-ordinated by Action on Smoking and Health:

[2] Statistics on Women’s Smoking Status at Time of Delivery, England – Quarter 4, 2015-16

[3] The Tobacco Control Plan for England ran between 2011 and 2015 and included the ambition to reduce rates of smoking in pregnancy to less than 11% by 2015.

[4] In November 2015 the Government announced plans to halve the number of stillbirths and infant deaths by 2030: Smoking is a major cause of stillbirths and infant death – estimated to be responsible for a third of perinatal deaths: ASH Factsheet on Smoking and Reproduction

[5] The Smoking in Pregnancy Challenge Group published a report in October 2015 calling for new Government targets to reduce smoking rates among pregnant women alongside a comprehensive range of measures: Smoking Cessation in Pregnancy: A review of the Challenge

ASH Research Report: Asthma and smoking

This Research Report examines asthma and smoking: the causes and the consequences.

ASH Research Report: Asthma and smoking

Smoking Cessation in Pregnancy – A call to action

Smoking during pregnancy causes up to 2,200 premature births, 5,000 miscarriages and 300 perinatal deaths every year in the UK. This report, by a coalition of baby charities, campaigners, leading academics and health experts, outlines recommendations for commissioners, providers, royal colleges, government bodies, training organisations and third sector organisations.

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