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Most CCGs missing smoking target for pregnant women

Smoking rates at delivery are over 17 times higher in worst CCG areas than others

Louise Prime

Thursday, 08 March 2018

Just one in six clinical commissioning groups (CCGs) in England are meeting the ‘national ambition’ that fewer than 6% of women should be smoking at the time they deliver their baby, NHS Digital reported this morning. It also found wide variation across the country, with smoking rates at delivery more than 17 times higher in some CCGs than the rates in others.

NHS Digital pointed out that one of the national ambitions in the Tobacco Control Plan published by the (then) Department of Health in July 2017 is ‘reducing smoking amongst pregnant women (measured at time of giving birth) to 6% by the end of 2022’. Despite this – and the fact that smoking during pregnancy can cause complications during labour and increase the risk of miscarriage, premature birth, low birth-weight and sudden unexpected death in infancy – a high proportion of women still smoke throughout pregnancy in some parts of England.

Its new figures (covering quarter three, 2017-18) give a measure of the prevalence of smoking among pregnant women broken down by commissioning region, region, sustainability and transformation partnership and CCG level. The data show that more than one in 10 pregnant women in England are still smoking at delivery, but this overall figure masks huge geographical variation – more than a quarter of women are still smokers at delivery in some CCGs, compared with fewer than one in 60 in other CCGs.

NHS Digital found that:
  • 10.8% of pregnant women were known to be smokers at the time of delivery. This compares to 11.0% for the previous quarter (quarter 2, 2017/18).
  • The CCGs with the lowest proportion of women known to be smokers at time of delivery were NHS Wokingham (1.6%), NHS Camden (2.4%) and NHS Hammersmith and Fulham (2.4%).
  • The CCGs with the highest proportions were NHS Blackpool (27.8%), NHS South Kent Coast (23.1%) and NHS South Tyneside (21.7%).
NHS Digital also reported that only 34 out of 207 CCGs in England met the new national ambition of 6% or less.

National Institute for Health and Care Excellence (NICE) public health guidance recommends that GPs and practice nurses caring for a pregnant women should use any appointment or meeting as an opportunity to ask her if she smokes; and if she does, they should explain how NHS Stop Smoking Services can help people to quit, and advise her to stop.

NICE adds that those with specialist training should provide pregnant women who smoke with information (for example, a leaflet, which should be available in a variety of formats) about the risks to the unborn child of smoking when pregnant. They should also provide information on the hazards of exposure to second-hand smoke for both mother and baby, and on the benefits of stopping smoking.

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