Smoking in pregnancy

Introduction

Reducing smoking during pregnancy is one of the three national ambitions in the national Tobacco Control Plan published in March 2011 (accessed 3 January 2017), which is “to reduce rates of smoking throughout pregnancy to 11 per cent or less by the end of 2015" (measured at time of giving birth).

Smoking in pregnancy has well known detrimental effects for the growth and development of the baby and health of the mother.

On average, mothers who smoke have more complications during pregnancy and labour including increased risk of:

  • bleeding
  • miscarriage
  • premature birth or still birth
  • placental abruption
  • pre-term rupture of membranes ('PPROM' - when the waters break before the baby is ready to be delivered)

Babies born to mothers who smoke are more likely to be at higher risk of:

  • low birth-weight
  • sudden unexpected death in infancy
  • serious respiratory illnesses (such as bronchitis and pneumonia)
  • other conditions such as asthma and glue ear

Some evidence links smoking in pregnancy with psychological problems in young children, such as attention and hyperactivity problems and negative and disruptive behaviours (Button, T, et al. 2007).

Key inequalities and risk factors

Pregnancy can be a powerful incentive to stop smoking and stopping smoking in pregnancy is the most effective step a woman can take to improve her health and the health of her baby. 

According to NICE, smoking during pregnancy is strongly associated with a number of factors including:

  • Age - Young mothers aged 20 years or under are five times more likely than those aged 35 and over to smoke during pregnancy
  • Occupation - Mothers in routine and manual occupations are more than four times as likely to smoke throughout pregnancy, compared to those in managerial and professional occupations.
  • Housing – Particularly pregnant women who live in rented accommodation
  • Relationship status – Particularly single women or women in a relationship with a partner who smokes
  • Educational attainment – Women with lower educational attainment are more likely to smoke

On going risk is also a cause for concern as whilst nearly half (49%) of mothers gave up before the birth, three in ten (30%) were smoking again less than a year after giving birth.  This impacts not only on the mother but the new born child. See the JSNA chapter on smoking for information on the dangers of secondary smoke.

Facts, figures and trends

The Public Health Inhale - INteractive Health Atlas of Lung conditions in England sets out the case for smoking cessation advice and support and its relevance to women who smoke during pregnancy who have a substantially higher risk of spontaneous abortion (miscarriage) than those who do not smoke. Smoking can also cause complications in pregnancy and labour, including ectopic pregnancy, bleeding during pregnancy, premature detachment of the placenta and premature rupture of the membranes.

In 2015/16, 10.6% of mothers were recorded as smokers at the time of delivery which is lower than 2014/15 (11.4%). This continues the steady year-on-year decline in the percentage of women smoking at the time of delivery from 15.1 per cent in 2006/07:

Prevalence of smoking in pregnancy at NHS Clinical Commissioning Group level is published quarterly in the Smoking Status at Time of Delivery (SATOD) collection. Headline data (extracted June 2015) shows:

  • a reduction in the proportion of women smoking at the time of delivery in the Bracknell and Ascot CCG area between 2013/14 and 2014/15 from 9.2% to 6.7%
  • the greatest year on year reduction in Thames Valley
  • the percentage of women smoking at the time of delivery is significantly lower than the national average

Source: Smoking at Time of Delivery (SATOD), PHE 2015

The reduction in the percentage of women smoking at time of delivery continues to 6.1% in Qtr 2 2016/17 (Statistics on Women’s Smoking Status at Time of Delivery, NHS Digital, 2016, accessed 3 January 2017)

Looking specifically at the Bracknell Forest council area, the Public Health Outcomes Framework highlights a significant and ongoing downward trend in the proportion of Bracknell Forest mothers smoking at the time of delivery compared to the average for the south east and for England:

Prevention, care, support and management

Local NHS Stop Smoking services - design and deliver targetted personal as well as whole family communication, support and signposting to women who smoke who:

  • are planning a pregnancy
  • are already pregnant
  • have an infant aged under 12 months
  • live in a household with others who smoke

The NHS stop smoking service serving Bracknell Forest is smokefreelife Berkshire which offers advice, information and support in person and online and in group and one-to-one settings as well as training to professionals and providers.

Want to know more?

National Child and Maternal Health Intelligence Network – Dynamic Report for Bracknell Forest gives high level statistical data and analysis on smoking status at time of delivery

The Tobacco Control Plan for England (Department of Health, 2011) - set a national ambition to reduce rates of smoking throughout pregnancy to 11% or less by the end of 2015 (measured at time of giving birth).  In addition to a new regulatory framework around tobacco sales and promotion, the document also highlights approaches to help people quit smoking.

Health Matters: Giving every child the best start in life (Public Health England, accessed 8 June 2016) - a resource for parents and professionals using or commissioning services, which brings together important facts, figures and evidence of effective interventions to tackle issues arising in the period from pregnancy to the age of two.

Smoking: acute, maternity and mental health services (NICE, 2013) - This guideline covers helping people to stop smoking in acute, maternity and mental health services.

Smoking: stopping in pregnancy and after childbirth (NICE, 2010) – guidance for commissioners and providers to encourage early referrals to and ongoing contact with local NHS stop-smoking service.

 

This page was created on 27 February 2014 and updated on 3 January 2017. Next review due December 2017.

Cite this page:

Bracknell Forest Council. (2017). JSNA – Smoking in Pregnancy. Available at: jsna.bracknell-forest.gov.uk/starting-well/maternity/smoking-pregnancy (Accessed: dd Mmmm yyyy)

 

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