Tobacco Control Strategy 2024 to 2029

Smoking during pregnancy poses significant health risks for both mothers and babies, including stillbirth, miscarriage, low birth weight, and sudden infant death syndrome. Quitting smoking is highly beneficial for the pregnant woman’s health and contributes to the wellbeing and development of the baby.

In England, smoking during pregnancy is tracked using Smoking at Time of Delivery (SATOD) data, with a government target of 6% by 202226. However, in England between 2022 to 2023, 8.8% of mothers smoked at the time of delivery, indicating a need for further progress to meet the target.

Buckinghamshire has shown improvement, with SATOD prevalence declining from 8% in 2014/2015 to 6.2% in 2022/202328. Yet, 6.8% of babies in Buckinghamshire have a low birth weight at term, exceeding the South East average of 6.2%.

To accelerate progress, the NHS Long Term Plan committed to implementing an opt-out smokefree pregnancy pathway by 2023/2024.

The Saving Babies’ Lives Care Bundle Version 2 (SBLCB2), 201930 focuses on reducing smoking in pregnancy. It recommends:

• Carbon monoxide (CO) testing of all pregnant women at antenatal booking appointment
• Carbon monoxide (CO) testing at 36 weeks
• Referral to a stop smoking service/specialist based on an opt out system
• Training on CO monitor use and Very Brief Advice (VBA) for all relevant maternity staff

In the United Kingdom (UK), around 207,000 children start smoking annually31. Two-thirds of adult smokers started before 18, and children with smoking parents are four times more likely to smoke themselves. Higher deprivation, higher levels of truancy and substance misuse are all associated with higher rates of youth smoking.

Smoking rates among under-16s in England hit record lows, with 12% having ever smoked and 3% currently smoking. In 2016, 48% of children reported second-hand smoke exposure, leading to health issues like respiratory infections and sudden infant death syndrome.

Concerns are rising over the growing popularity of disposable vapes among young people. The 2023 YouGov survey revealed a 50% increase in vaping (also known as e-cigarettes) experimentation, with current vaping rising from 3.2% in 2021 to 7.6% in 202336. Despite vaping being illegal for under 18s, most acquire vapes from shops or friends/adults/parents. Colourful, pocket-sized vapes with sweet flavours at cheap prices make them appealing and accessible to young people.

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To prevent the next generation of smokers and to discourage young people from starting vaping, smoking free environments such as Smokefree Parks and Playgrounds, Smokefree Sidelines and Smokefree Gates are important initiatives that will de-normalise smoking and vaping in communities.