NHS funding cuts could undermine progress in reducing smoking during pregnancy

Unprecedented progress in reducing the number of women smoking during pregnancy in England could be put at risk by NHS funding cuts, according to a UEA addiction expert.

A new BMJ article, co-authored by Prof Caitlin Notley from UEA's Norwich Medical School, reveals that the proportion of women smoking during pregnancy in England has almost halved in the last decade.

Most of the decline happened in the last five years thanks to the introduction of dedicated stop smoking advisers in NHS maternity services since 2020.

But the team fear that the reduction could be threatened by cost-cutting exercises.

And they are calling for continued investment to give every child a smokefree start in life.

The article has been written by members of the Smoking in Pregnancy Challenge Group - a coalition of organisations committed to reducing rates of smoking in pregnancy.

It shows how the amount of women smoking during pregnancy dropped from 11.7 per cent in 2014/15 to 5.9 per cent as of Q3 2024/25.

The progress on reducing rates of smoking in pregnancy has accelerated in recent years, thanks to the focused efforts of all healthcare professionals involved in the pregnancy care pathway.

However, there remain significant inequalities, as rates of smoking remain higher in deprived areas - suggesting that we need innovative targeted approaches for those who really struggle to quit."

Prof. Caitlin Notley, Professor of Addiction Sciences at UEA

The authors say that cuts to integrated care boards (ICB) budgets and the loss of ringfenced funding for NHS tobacco treatment services could threaten the success.

Stop smoking support in some hospitals and mental health services has already been cut, according to the group, with further cuts expected.

The Smoking in Pregnancy Challenge Group is a partnership between the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health, the voluntary sector and academia.

Prof Linda Bauld, director of the SPECTRUM Research Consortium, co-chair of the Smoking in Pregnancy Challenge Group and co-author of the BMJ article said: "The evidence is clear that stop smoking support for pregnant women has played a vital role in reducing rates of maternal smoking and saving babies' lives. Without continued investment in these services there is a real risk that this decline could stall, or even start to reverse, with tragic consequences for parents and families." 

Dr Clea Harmer, chief executive of Sands and co-chair of the Smoking in Pregnancy Challenge Group, said: "As the government sets its sights on a smokefree generation, now is not the time to be cutting investment in these services. Instead, they should be going further and faster to ensure every child has a smokefree start in life."

John Waldron, policy and public affairs manager at Action on Smoking and Health and co-author of the BMJ article said: "The 2024 Labour manifesto committed to ensuring that all hospitals integrate smoking cessation support into routine care. The government must deliver on this commitment by protecting funding for these lifesaving services."

'NHS Cuts Could Spark Surge in Smoking During Pregnancy, Experts Warn' is published in the British Medical Journal (BMJ).