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New Government Tobacco Control Plan Tackles Smoking in Pregnancy

Media release on behalf of the Smoking in Pregnancy Challenge Group (of which iPiP is a member):

Reducing smoking during pregnancy is a key objective of the Government’s new Tobacco Control Plan for England, “Towards a Smokefree Generation”, published today describing it as: “critical to our drive to ensure children have the best start in life”. [1] The new Plan has been welcomed by the Smoking in Pregnancy Challenge Group, which consists of Royal Colleges of medicine, third sector organisations and academics and researchers. [2]

Smoking while pregnant increases the risk of complications during pregnancy and while giving birth, makes babies more likely to be born underweight and prematurely, even to be stillborn, and increases the risk of cot death (sudden infant death syndrome). There is wide geographic variation in smoking rates in pregnancy and it is a significant factor in health inequalities. [3] The new plan commits to tackling this variation through ensuring NICE guidance on smoking in pregnancy is properly implemented.

The most recent Government figures show that progress to reduce rates of smoking in pregnancy has slowed in the last year and it is hoped that commitments in the new plan will help to reverse this trend. [4]

Key commitments in the new Plan

  • Reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less.
  • Local areas are encouraged to identify ‘Smokefree Pregnancy Champions’
  • Carbon Monoxide testing at antenatal care and referral to stop smoking services
  • Record the outcome of Carbon Monoxide screening within the Maternity Services Dataset, which is the standard record of maternity care
  • Public Health England will analyse current practice in maternity services, to assess the use of CO monitoring and the implementation of smokefree policies across England
  • PHE and NHS England will develop a joint work plan setting out recommendations for how local areas can work together
  • PHE will continue to work with the Smoking in Pregnancy Challenge Group.

The Challenge Group welcomes these commitments, but warns that local resources are needed to support pregnant women in quitting, and to ensure that care pathways between maternity, primary care and public health are joined up. This also requires filling the gaps in training for midwives and obstetricians as identified in the Group’s report Smokefree Skills; a review of maternity workforce training published today [5].

Francine Bates, Chief Executive of the Lullaby Trust and co-chair of the Smoking in Pregnancy Challenge Group said:

“I’m very pleased to see that the Government has made tackling smoking during pregnancy a priority in the new Plan and have pledge to continue to work with the Smoking and Pregnancy Challenge Group on this issue. Infant mortality is still too high because of smoking. We have succeeded in cutting smoking rates, but recently progress has slowed. The Government’s new commitments are valuable, but we think that additional resources will be needed to support pregnant women in quitting, to provide suitable training for health staff, and to make sure NHS and public health services speak with one consistent voice to offer advice and referral to good support services.”

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

“The new Plan sets clear targets and promises Government action and NHS action. Now this national plan must be joined up with effective and well-resourced services as a local level. If this doesn’t happen, we could see widening health inequalities, as the women who most need help and support do not receive it”




[1] https://www.gov.uk/government/publications/towards-a-smoke-free-generation-tobacco-control-plan-for-england The previous Plan expired at the end of 2015.

[2] The Smoking in Pregnancy Challenge Group was established in 2012 in response to a challenge from the then Public Health Minister to produce recommendations on how the smoking in pregnancy ambition contained in the Government’s tobacco strategy could be realised. The Group presented their report and recommendations to the Public Health Minister in June 2013 and continues to meet annually to review progress. www.smokefreeaction.org.uk/SIP/index.html

Challenge Group members are: Royal College of Midwives; Royal College of Obstetricians & Gynaecologists; Royal College of General Practitioners; Royal College of Nursing; Royal College of Paediatrics and Child Health; The Lullaby Trust; the UK Centre for Tobacco Control Studies; Action on Smoking and Health; Tommy’s; Bliss; the Faculty of Public Health; the National Centre for Smoking Cessation & Training; the Community Practitioners and Health Visitors Association; Sands – the stillbirth and neonatal death charity; the Institute of Health Visiting; the Royal Society for Public Health; Fresh and the Tobacco Control Collaborating Centre

[3] Statistics on smoking at time of birth, collected by NHS England, show that in the last quarter of 2016/17 The CCGs with the lowest proportion of women known to be smokers at the time of delivery were NHS West London (2.3 per cent), NHS Richmond (2.5) and NHS Hammersmith and Fulham (2.7), while the CCGs with the highest proportion were NHS Blackpool (28.1 per cent), NHS Hull (22.9) and NHS North East Lincolnshire (22.3).

[4] Between 2015/16 and 2016/17 smoking in pregnancy rates only dropped by 0.1% compared to 0.8% in the previous year: http://www.bbc.co.uk/news/health-40286702

[5] ASH, Smokefree Skills: a review of maternity workforce training, July 2017 http://ash.org.uk/wp-content/uploads/2017/07/Executive-summary-of-Smokefree-Skills-report-final.pdf


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