Smoking at Time of Delivery Rates had been steadily falling and the Government announced in July a target to reduce the rates to 6% or less by 2022 [1]. However, this morning results show that progress nationally appears to be stalling with no decline reported in the first two quarters of the year. In 2016/17 the rate of smoking in pregnancy was 10.7% but this morning’s figures show no progress with 11% of women smoking throughout their pregnancy [2].

The national picture hides significant local variations. While 89 CCGs have seen rates decline by 1 percentage point or more since 2014/15, 78 CCGs have seen them increase. In areas like Sheffield that have invested in evidence based support for pregnant women with midwives trained to provide expert support alongside health visitors and others they have seen the rate of smoking among pregnant women tumble with rates falling by 4.1 percentage points since 2014/15. By contrast areas that have cut services are not seeing the same rate of progress.

The Smoking in Pregnancy Challenge Group [3], a coalition of health charities, academics and health professionals working to support the Government ambition to reduce smoking rates in pregnant women, is concerned that unless more action is taken to bring the worst performing areas up to the level of the best.

While there has been a lot of national and strategic activity to address rates of smoking among pregnant women, and there are clearly parts of the country making significant progress in bring rates down, this is not a universal picture. In many areas there have been major cuts to services available to help smokers quit.

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

“There are big opportunities through the local maternity transformation work to ensure that every women who needs it has access to treatment to help her quit smoking. Local areas that are falling behind must seize this opportunity.”

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

“We welcomed the announcements from Government last week that there would be further investment in training for midwives to support smoking cessation but more must be done to address the big variation in performance between areas. We know there are local challenges but we can learn from the places getting it right and ensure world class support is available to all.”

Notes and references

[1] Department of Health, Tobacco Control Plan for England, July 2018

[2] NHS Digital, Smoking at Time of Delivery Q2, 7th Dec 2017

[3] The Smoking in Pregnancy Challenge Group was set up in 2012 in response to the Government’s then ambition to reduce rates of smoking in pregnancy. For more information see:

For further information, please call Hazel Cheeseman, Director of Policy, Action on Smoking and Health on 020 7404 0242 or 07754 358 593. You can also email

Full membership of the Smoking in Pregnancy Challenge Group:

  • ASH
  • Bliss
  • Community Practitioners and Health Visitors Association
  • Faculty of Public Health
  • Family Nurse Partnership
  • Fresh
  • Institute of Health Visiting
  • Royal College of GPs
  • Royal College of Midwives
  • Royal College of Nursing
  • Royal College of Obstetrics and Gynaecology
  • Royal College of Paediatrics and Child Health
  • Royal Society of Public Health
  • Sands
  • The Lullaby Trust
  • Tobacco Control Collaborating Centre
  • Tommy’s
  • Unite