Mums urged to quit smoking whilst pregnant

Date published: 28 June 2010

All pregnant women should be encouraged to have their carbon monoxide levels tested to determine whether they smoke, thereby ensuring that pregnant smokers receive appropriate support to quit for the good of their unborn baby, according to the National Institute for Health and Clinical Excellence (NICE).

This change to current clinical practice is one of a number of recommendations in new guidance published this week by NICE, to help women and their families give up smoking during and after pregnancy.

Smoking during pregnancy can increase the risk of miscarriage, premature birth, still-birth and sudden unexpected death in infancy.

It is thought to cost the NHS between £20 million and £87.5 million each year to treat mothers and small infants under 12 months old with problems caused by smoking in pregnancy.

To tackle this issue, new NICE guidance calls on midwives to assess every woman’s carbon monoxide levels at their first antenatal appointment by encouraging women to have a special breath test.

The guidance also recommends that women who smoke and are either pregnant or have recently given birth, are offered a range of options to help them quit, including automatic referral to smoking cessation services and sensitive and non-judgemental support by professionals.

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE, said: “We’ve known for many years that smoking and passive smoking can cause serious illnesses like lung cancer. During pregnancy, smoking puts the health of the women and her unborn baby at great risk both in the short and long-term, and small children who are exposed to second-hand smoke are more likely to suffer from respiratory problems.

“One of our recommendations is for midwives to encourage all pregnant women to have their carbon monoxide levels tested and discuss the results with them. This isn’t to penalise them if they have been smoking, but instead will be a useful way to show women that both smoking and passive smoking can lead to having high levels of carbon monoxide in their systems. It will also alert non-smokers with high carbon monoxide levels to possible CO poisoning, which can be caused by a faulty boiler or car emissions.”

In 2005, almost one third of mothers smoked before or during pregnancy. Despite nearly half (49%) of these women giving up before the birth of their baby, three in ten were smoking again less than a year after childbirth. Younger women aged under 20 are five times more likely to smoke while pregnant than women over 35 years old. Smoking during pregnancy is also more common in women who are less educated, are not homeowners and are either single or live with a partner who smokes.

The guidance contains recommendations for GPs, midwives, health visitors and others involved in antenatal and postnatal services, as well as other professionals including dentists, pharmacists and those working in smoking cessation services, fertility clinics, children’s centres, voluntary organisations and local authorities.