National guidance and policy
This page provides an overview of national guidance and policy relating to smoking in pregnancy.
- Smoking in pregnancy Challenge Group reports
- Guidance and policy
- Response to inquiry on e-cigarettes
Smoking in Pregnancy Challenge Group Reports
The Challenge Group has produced four reports reviewing the progress made in reducing smoking in pregnancy in England. These reports provide a useful overview of the policy landscape at the time of publication and make recommendations to reduce the rate of smoking in pregnancy.
- Smoking Cessation in pregnancy: A call to action (2013)
The first Challenge Group report outlines a range of recommendations for reducing the prevalence of smoking during pregnancy.
- Smoking Cessation in Pregnancy: A review of the Challenge (2015)
This Challenge Group report which was published following the conclusion of the 2015 tobacco control plan for England and reviews the Group’s original recommendations and defines a new mandate for the next five years.
- Smoking in pregnancy Mapping Project Report (2016)
This report was commissioned by Public Health England and the analysis was conducted by the Tobacco Control Collaborating Centre. Case studies of services available for pregnant smokers and their families can be viewed here.
- Smokefree Skills: an assessment of maternity workforce training (2017)
This report, published by ASH and the Challenge Group, provides an analysis of the training that midwives and obstetricians receive to address smoking in pregnant women, and what further training is needed. You can read the full report here and the executive summary of the report here.
- Review of the Challenge (2018)
This Challenge Group report includes a new analysis estimating the positive impact of achieving the Government’s target to reduce smoking in pregnancy to 6% or less by 2022 and outlines recommendations for the next steps. The Lullaby Trust have produced a report detailing the methods behind the statistics in the report. Download here (pdf).
Guidance and policy
NICE guidance providing the evidence-based model for smoking cessation support within maternity settings:
- PH48 ‘Smoking: acute, maternity and mental health services’
- PH26 ‘Smoking: stopping in pregnancy and after childbirth’
The Saving Babies’ Lives Care Bundle Version 2 (2019) – ‘Element 1: Reducing smoking in pregnancy’ recommends carbon monoxide (CO) testing of all pregnant women at antenatal booking appointment; CO testing a 36 weeks; referral to a stop smoking service/specialist based on an opt out system; and training on CO monitor use and Very Brief Advice (VBA) for all relevant maternity staff. An evaluation of the Care Bundle found that stillbirths fell by a fifth at maternity units where the guidance was implemented, saving more than 160 babies’ lives. You can read the NHS press release here. Version 1 of the Saving Babies’ Lives Care Bundle can be accessed here.
The NHS Long Term Plan, published January 2019, includes a commitment to deliver an opt-out smokefree pregnancy pathway including focused sessions and treatments for expectant mothers and their partners. Areas with the greatest level of need will be prioritised with a commitment to support 600,000 people to quit over the next five years. The press release which includes a quote from Dr Clea Harmer, co-chair of the Challenge Group, can be found here.
The 2017 Tobacco control plan for England includes an ambition to reduce rates of smoking in pregnancy to 6% or less by 2022. The Plan further commits Government to a number of specific actions including commitments to embed CO Screening in Maternity Services Data Set and to take further action via the Maternity Transformation Programme.
Response to inquiry on e-cigarettes
In December 2017 the Smoking in Pregnancy Challenge Group submitted its response to the House of Commons Committee on Science and Technology Inquiry into e-cigarettes. You can read the submission here and learn more about the inquiry here.