Smoking during pregnancy can have significant consequences for mother and baby, and increases the risk of stillbirth, miscarriage and preterm birth (National Childbirth Trust, 2018; NHS, 2019). The National Childbirth Trust (2018) emphasises that the impacts of smoking in pregnancy can be longer term as well, putting babies and children at increased risk of asthma, chest and ear infections, as well as psychological problems.
Despite the known risks, in England, around 1 in every 14 mothers (7.3%) are known smokers at the time of birth, according to data from NHS Digital (2024). The national ambition is to reduce this proportion to 6% or less, and was originally set as a target for 2022 (Department of Health and Social Care, 2020).
Reducing the rate of smoking in pregnancy is a key priority throughout healthcare services. The NHS (2019) long term plan includes goals for supporting expectant mothers and their partners to quit smoking. The first element of the ‘saving babies' lives’ care bundle focuses on how to reduce smoking in pregnancy (NHS England, 2023), and the National Institute for Health and Care Excellence (2023) has published guidance on treating tobacco dependence in pregnant women.
Despite widespread efforts to reduce smoking in line with these goals, a recent study reported a rise in smoking prevalence among women of reproductive age (Jackson et al, 2024). This 10-year population study in England found that in particular, women in more advantaged social grades were now more likely to smoke and/or vape, based on data from 2013–2023.
The NHS (2023) highlights that protecting a baby from tobacco smoke is ‘one of the best things you can do to give your child a healthy start in life’. There is a wider campaign to make England ‘smokefree’ by 2030, with the goal of reducing adult smoking prevalence to 5% or less (Balogun and Harker, 2023). It is described as an ‘extremely challenging target’, but one that has been echoed in similar smokefree targets for Scotland and Wales (Balogun and Harker, 2023).
I know that midwives play an important role in supporting the reduction of smoking in pregnancy. I hope that this will help contribute to making the UK a safer, healthier space for women and their babies.