Smoking Prevalence Among Pregnant Women Remains High

Data from Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016) published by the Health & Social Care Information Centre (HSCIC) reveals that smoking prevalence among pregnant women in England continues to decrease. In 2015/16, the national smoking prevalence at time of delivery was 10.6% which is a decrease of nearly 1% since 2014/15 when 11.4% of women were smoking at the time of giving birth. What is also very encouraging to know is that the smoking prevalence among pregnant women at time of delivery finally reached the national ambition of 11% at the annual level.

Though the declining trend of smoking prevalence among pregnant women in England is promising, the percentage of women smoking at time of delivery remains quite high compared to the national average for the general population. The latter is according to the latest data by Public Health England (PHE) just below 17%.

2015/16 HSCIC Report Reveals Major Variations in Smoking Prevalence at Time of Delivery

Figure 1:

2015/16 Smoking Prevalence Among Pregnant Women at Time of Delivery in Selected Cities in England

Data Source: Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016), HSCIC

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Figure 1 reveals a major difference in smoking prevalence among pregnant women at time of delivery between particular cities. The lowest smoking prevalence was recorded in London – 4.9%, followed by Birmingham (7.4%) and Reading (7.8%); the only two of the selected cities with fewer than 10% of women identified as smokers at the time of giving birth. Blackpool had the highest smoking prevalence which reached a staggering 26%.

The North-South Divide in Smoking Prevalence at Time of Delivery Mirrors the Traditional South-North Smoking Divide

Data source: Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016), HSCIC

Table 1 shows that only the London and South of England Commissioning Regions reached the national ambition of 11%. But it also exposes a major north-south divide, showing that the northern regions are less likely to reach the national target. At the same time, they are more likely to have a higher rate of women smoking at the time of birth than the most southern regions. This mirrors the traditional north-south divide, as the North of England, especially the North East consistently having higher rates of smokers.

Although the smoking prevalence in North England has declined significantly, the northern regions of the country still lag behind their southern counterparts. According to the latest PHE data, the North East has the highest prevalence of smokers – 18.7%, with the North West, and Yorkshire and the Humber falling behind just 0.1%. In contrast, there are only 15.5% of smokers in South West and just a fraction more in West Midlands and South East. In London, there are an estimated 16.3% of smokers. Why Northerners are more likely to smoke than Southerners remains unclear but it has been shown that smoking rates are closely linked to socio-economic factors. These also include income and employment status, both of which are working to the disadvantage of the North.

Comparison to the Smoking Prevalence at Booking Appointment Not Encouraging

The results of the nationwide campaign to reduce the number of women smoking during pregnancy are encouraging. If the rates of women smoking during pregnancy decline at the current rate, there is a great chance that the next national ambition of 6% will be reached by 2020. A comparison of smoking prevalence at time of delivery to smoking prevalence at booking appointment (this usually occurs within first 10 weeks of pregnancy), however, is less encouraging. Analysis of Maternity Services Reports from April 2015 to March 2016 reveals that in the same period, smoking prevalence among pregnant women at booking appointment was 12.3% at the national level.

Data source: Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016), HSCIC; Maternity Services Reports (April 2015 to March 2016), NHS Digital 

Table 2 reveals that, just like the smoking prevalence among pregnant women at time of delivery, the rate of smokers at booking appointment is the lowest in the London Commissioning Region, while the North of England again performed the worst. But what is particularly concerning is that smoking prevalence at time of delivery wasn’t much lower from the smoking rates at booking appointment.

To summarise, the figures suggest that only a fraction of women who smoked at their booking appointment quit by the time of giving birth.

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