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Health and Social Care Information Centre. Statistics on Women's Smoking Status at Time of Delivery: England. 2014. (accessed 25 June 2014)

Owen L, McNeill A Saliva cotinine as an indicator of cigarette smoking among pregnant women. Addiction. 2001; 96:(7)1001-6

Tommy's. Smoking and Pregnancy. 2014. (accessed 25 June 2014)

Positive steps in public health

02 July 2014
Volume 22 · Issue 7

It isn't often that there is so much good news in the press surrounding midwifery. On 19 June the Health and Social Care Information Centre (HSCIC, 2014) released new figures showing the prevalence of women giving birth who classed themselves as smokers at the time was the lowest it has been in 8 years. Rates have fallen from 15.1% since they were first measured in 2006-07 to 12% this year. So we are well on the way to achieving the Government-set target of 11% by 2015 (Department of Health, 2013).

The risks of smoking in pregnancy are well established. Research has shown that smoking in pregnancy is directly linked to problems including (Tommy's, 2014):

  • ■ Miscarriage
  • ■ Premature birth
  • ■ Low-birth weight
  • ■ Stillbirth
  • ■ Sudden infant death syndrome.


With such potentially devastating risks to the unborn child, this target of 11% is still too high. No women should be classing themselves as smokers at the time of delivery.

Despite over one third of clinical commissioning groups (CCGs) more than achieving the Government's target, there was a great variance among the results (1.9% for NHS Central London (Westminster) and NHS Richmond, and 27.5% for NHS Blackpool) (HSCIC, 2014). I don't want to discount the great work midwives and health professionals have done, especially as evidence has suggested that women who smoke during pregnancy are reluctant to discuss their addiction with their midwives and often fail to admit to smoking when asked during their initial antenatal appointment (Owen and McNeil, 2001), making it almost impossible for midwives to provide the much-needed support and information on smoking cessation. The public health message is clearly having an impact despite the lack of resources and the shortage of midwives. Keep up the good work.

On the subject of good news, earlier this month, a number of midwives have been recognised in the Queen's birthday honours. The list includes one of our new board members, Gillian Smith, RCM Scotland director, who was awarded an MBE for services to midwifery and partnership in Scotland; and Birthwrite columnist and President of the RCM, Lesley Page who was awarded a CBE for services to midwifery. On behalf of all of us at the British Journal of Midwifery, we would like to congratulate Gillian and Lesley on this wonderful achievement!