Smoking in Pregnancy

This topic area covers statistics and information relating to smoking in pregnancy in Hull including local strategic need and service provision. Further information relating to smoking is also available under Smoking Among Adults under Lifestyle Factors within Adults and under Smoking Among Young People under Lifestyle Factors within Children and Young People.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• Tobacco is a unique product. It is the only consumable that, when used in the intended way, kills half of its users.
• As smoking and deprivation is associated this acerbates the inequalities associated with poverty and deprivation. Smoking is the single greatest cause of inequality, and it also accounts for approximately half of the difference in life expectancy between the lowest and highest deprivation groups.
• The risks of smoking during pregnancy are serious from premature delivery to increased risk of miscarriage, stillbirth or sudden infant death. If parents or carers smoke in or outside the home, there are further risks to the newborn, infant and child later in life.
• In 2018/19, 23.2% of women in Hull were recorded as smokers in early pregnancy at their first antenatal (booking) appointment.
• In 2020/21, 669 women were recorded at the time of their delivery as having smoked during their pregnancy representing 20.8% of women. This was more than twice as high as England (9.6%). The prevalence of smoking in pregnancy in Hull has fallen slightly since 2010/11 when it was 23.4%, but there has been no real change recently and the rates have increased over the last two years from 19.9% in 2018/19.
• Pregnancy can be a key point in people’s lives, and it is important to maximise such opportunities to quit smoking when quit attempts are more likely to be successful.
• There is a dedicated Bump the Habit service to help pregnant women quit smoking.

The Population Affected – Why Is It Important?

Tobacco is a unique product. It is the only consumable that, when used in the intended way, kills half of its users. This makes it one of the biggest causes of death and illness in the UK. Every year, there are around 64,000 deaths attributable to smoking in England. Smokers who die prematurely lose on average about 10 years of life.

The estimated to cost of smoking in England is in excess of £17 billion per year, and in addition it is estimated that people in England spend around £12 billion every year on legal and illegal tobacco products (just under £2,000 per smoker).

As smoking and deprivation are associated this acerbates the inequalities associated with poverty and deprivation. Smoking is the main contributor to health inequalities. Marmot in his original report in 2010 stated that smoking accounts for approximately half of the difference in life expectancy between the lowest and highest groups. It is estimated that over one million children were living in circumstances of severe financial deprivation whose plight is exacerbated by parental smoking (further specific details are given within Smoking Among Young People under Lifestyle Factors under Children and Young People).

There are also specific serious risks to the baby if their mother smokers during pregnancy. There is an increased risk of premature delivery, miscarriage, stillbirth or sudden infant death. People who smoke breathe in more than 4,000 chemicals from the cigarette which go from the lungs to the bloodstream with that blood flowing directly to the baby via the placenta and umbilical cord. This causes the baby to struggle for oxygen, and one of the chemicals found in cigarettes is carbon monoxide, a dangerous chemical that gets into the bloodstream which can restrict oxygen supply essential for the baby’s healthy growth and development. This can cause the baby’s heart to pump even harder. Smoking can also result in babies born with low birth weight. As the baby is completely dependent on the women during pregnancy, a baby can also suffer nicotine withdrawal once it is born if the mother continued to smoke throughout pregnancy. This can make the baby stressed and irritable and it may be difficult to stop them crying. Smoking during pregnancy also increases the risk of sudden infant death by at least 25%.

Second-hand smoke is very dangerous for anyone exposed to it, but it is particularly dangerous for children. Children exposed to second-hand smoke are at risk of ear infections, chest infections, bronchitis, pneumonia, breathing problems, allergies, asthma attacks and meningitis. Furthermore, nearly three quarters of children worry that their mum or dad will die because they smoke. Not only that, but if someone smokes in the household, children are three times more likely to smoke when they grow up.

The health impacts of quitting smoking can be found in Smoking Among Adults under Lifestyle Factors under Adults.

The Hull Picture

Women in Hull are much more likely to smoke in early pregnancy with almost one-quarter doing so in Hull in 2018/19. The percentages are presented below from The Office for Health Improvement & Disparities’ Fingertips, and more recent data is not available.

Whilst the prevalence in Hull is high it is not the highest in Yorkshire and Humber.

The percentage of women who continue to smoke throughout their entire pregnancy is high. The percentage of women known to be current smokers at the time of their delivery in Hull is more than twice as high as England for 2020/21 (20.8% versus 9.6%).

The rate in Hull is the highest of local authorities in the Yorkshire and Humber region, and many of the local authorities across the region have rates that are statistically significantly higher than England.

During 2020/21, 669 pregnant women were recorded as current smokers at the time of delivery in Hull.

The percentage of smoking throughout pregnancy has reduced slightly over the last decade, but the reduction has been relatively slow and the percentage has remained relatively unchanged in the last 3-4 years.

In Hull during 2020/11, 23.4% of pregnant women smoked throughout their pregnancy, and this fell to a low of 19.9% in 2018/19. In the last two years, the percentage has increased slightly to its current level of 20.8%. In contrast, the percentage of women who were recorded as current smokers at the time of delivery across England and the region has shown a consistent decline over time.

Hull is the fourth most deprived local authority in England based on the Index of Multiple Deprivation, and smoking prevalence is strongly associated with deprivation as illustrated within Smoking Among Adults and Smoking Among Young People (both within Health Factors under Adults and Children and Young People respectively). Whilst local information does not exist on the prevalence of smoking in pregnancy by local deprivation group, it is clear that the high levels of smoking in pregnancy can be attributable – at least in part – to the high levels of deprivation in Hull. Social norms may also play a part in Hull.

Strategic Need and Service Provision

The aims of SmokeFree Hull are to actively promote a smoke-free City, support quit attempts through pharmacotherapies and behavioural support and harness the wider public health workforce to deliver very brief advice to people they have contact with (“make every contact count”). The service works with other health care providers to access existing networks ensuring access to information and support is widely available.  The Service uses a variety of methods to meet the needs of smokers and their families.

People who smoke are more likely to stop at key points in their lives such as when their circumstances change with regard to changes to their education, employment, living arrangements or health. Such a key point moment in life is during pregnancy, and SmokeFree Hull maximise this opportunity working with pregnant women so that both the woman and her partner can stop smoking. This improves life of the baby through direct effects of parental smoking, but also through indirect effects such as household finances, healthier parents and changing social norms for that child with respect to smoking.

The current adult SmokeFree Hull Service has a priority focus on people living in the most deprived wards (where smoking prevalence is the highest), pregnant women, and people with chronic obstructive pulmonary disease, coronary heart disease and mental health illness. Preventing children and young people smoking is an important element of reducing prevalence and improving their health, and there is a dedicated service for children and young people. There is also a dedicated stop smoking website Bump the Habit to help pregnant women quit smoking.

Hull Alliance on Tobacco is a multi-agency Alliance working collaboratively to reduce smoking prevalence. Helping smokers quit is one strand of the Alliance’s Plan which recognises other aspects of tobacco control are needed. This broader approach is supported by the Tobacco Plan for England, World Health Organisation, National Institute of Health and Care Excellence (NICE) and the Regional Tobacco Control Group.

In practice this means that in addition to helping people quit, Hull has effective regulation and enforcement through Trading Standards to reduce the availability of illicit tobacco, underage sales and enforcement of smokefree laws, work in partnership with the NHS as they become smokefree and support all areas through multi-media communication.

The core areas for HALT partners include mental health (parity of esteem), illicit tobacco, e-cigarettes, marketing, and children and young people (denormalising smoking). We want not smoking to be seen as the norm in all local communities. The HALT plan has three key priorities: smoking in pregnancy, supporting a smoke free NHS and health inequalities.

Resources

NHS. Smoke Free: Stopping smoking is the best thing you can do for your baby: https://www.nhs.uk/smokefree/why-quit/smoking-in-pregnancy

The Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

NHS Digital. Statistics on Women’s Smoking Status at Time of Delivery: England. https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england

Action on Smoking and Health: https://ash.org.uk/home/

Smokefree Hull: https://www.changegrowlive.org/smoke-free-hull

Bump the Habit: www.bumpthehabit.org.uk

National Institute of Health and Care Excellence (NICE) Guidance NG29. https://www.nice.org.uk/guidance/ng209

Health Equity in England: The Marmot Review 10 Years on. https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on

Updates

This page was last updated on 25 August 2022.

This page is due to be updated / checked in December 2022.