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Tobacco use in pregnancy

ASH Scotland information briefing on tobacco use in pregnancy
(updated September 2012)

Key points:

  • smoking is the single largest preventable causeof foetal and infant morbidity in the UK
  • smoking in pregnancy affects the health of mother and baby so the focus  should not just be on the baby
  • women should be supported to quit rather than put under pressure to do so
  • smoking increases the risk of pregnancy-related illness and complications
  • maternal exposure to second-hand smoke also has adverse health effects for the mother and the foetus
  • exposure to second-hand smoke is a serious health threat to infants
  • smoking cessation is an effective intervention which has immediate and long term health benefits for pregnant women and families.

Epigenetics

Figures for Scotland

In Scotland:

  • NEW quit attempts 27 May 2014
    in 2013, there were 2,918 quit attempts made by pregnant women, a decrease of 155 of the 2012 figure of 3,073.   NHS Smoking Cessation Service Statistics (Scotland) 1st January to 31st December 2013.  Available from: Information Services Division (ISD) Scotland publications page [accessed 27 May 2014]
  • the number of women who were smokers at the time of their booking appointment fell from 25.4% in 2000/01 to 18.4% in 2012/13. The level of 'Not Known' has decreased from 13.5% in 2000/01 to 4.6% in 2012/13. It should be noted that the percentage of ‘unknowns’ may include a proportion of smokers and it is also known that there is considerable under-reporting of smoking by pregnant women themselves.
    Births in Scottish Hospitals - year ending 31st March 2013, summary, published 26th August 2014, Information Services Division Scotland [Accessed 27 August 2014]
  • 29.8 of women who were current smokers at booking were in the most-deprived quintile (SIMD 1) and 22.2 in SIMD 2, compared to 6% in the least deprived quintile (SIMD 5).  See table 10, Births in Scottish Hospitals, Information Services Scotland [accessed 27 August 2014]
    NB Also see table 11 for figures at first visit (recorded during the health visitor’s first visit to a woman and her new baby following the birth, usually around 10 days post-partum).
  • there is evidence that self-reported smoking is under-reported and that the true smoking figures for pregnant women may be underestimated by up to 25%.
    Source: Shipton D, Tappin D, Vadiveloo T, Crossley J, Aitken D, Chalmers J. Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study. BMJ 2009;339:b4347.  www.bmj.com/content/339/bmj.b4347.full [Accessed 06.09.12]
  • 73% of BC2 (birth cohort 2 from 1st March 2010 and 28th February 2011) women never smoked during pregnancy, compared with 75% in BC1 (birth cohort 1 in 2005), but a further 9% of BC2 stated that they gave up once they discovered they were pregnant (a response option not offered in BC1).
    Source: Growing Up in Scotland: Birth Cohort 2. Results from the First Year. Scottish Government, 20 February 2013.  Available from:
    www.scotland.gov.uk/Publications/2013/02/3280/2 [Accessed 20 Feb 2013]

UK

The UK Infant Feeding Survey 2010 (published November 2012) reports that:

  • around a quarter of mothers (26%) in the UK smoked in the 12 months before or during their pregnancy, which was down from a third (33%) in 2005. Lower levels of smoking were seen in all countries in the UK
  • across the UK, the proportion of mothers smoking before or during pregnancy fell from 33% to 26% between 2005 and 2010. Lower levels of smoking were seen in all countries in 2010 compared to 2005. The most significant decreases in smoking levels before or during pregnancy were in Scotland, where smoking levels fell from 35% to 27%, and in England, where they fell from 32% to 26%.
  • mothers in Wales were the most likely to have smoked before or during pregnancy (33%) and mothers in England the least likely (26%)
  • twelve per cent of mothers continued to smoke throughout their pregnancy, down from 17% in 2005
  • of mothers who smoked before or during their pregnancy, over half (54%) gave up at some point before the birth
  • the highest levels of smoking before or during pregnancy were found among mothers in routine and manual occupations (40%) and among those aged under 20 (57%). Mothers aged under 20 were also the least likely to have given up smoking at some point before or during pregnancy (38%), but by socio-economic group, mothers who had never worked were the least likely to have done so (29%)
  • almost nine in ten mothers (88%) who were smoking before or during pregnancy received some type of information on smoking. Midwives were the most common source of information, mentioned by 85% of mothers who had received information. Almost a third of mothers (32%) lived in a household where at least one person smoked during their pregnancy, including just under one in five (19%) where only other people smoked (not the mother herself)
  • at Stages 2 and 3 (when babies were around four to six months old and eight to ten months old respectively), three per cent of infants lived in a household where at least one person ever smoked in the home.

Chapter 11, NHS Information Centre, Infant Feeding Survey
www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/infant-feeding-survey/infant-feeding-survey-2010 [Accessed 06 December 2012]

For further ASH Scotland information see:

The evidence base:

Key topics Economics Inequalities Stopping smoking Second-hand smoke Young people Tobacco control legislation in Scotland Illicit tobacco Tobacco industry interference Tobacco use in pregnancy Global tobacco control Tobacco endgames