Smoking during Pregnancy

By Dr Joe Kabyemela, MD

There is little doubt that smoking during pregnancy is a significant health problem in many countries throughout the world. The extent of the problem varies from region to region and from country to country but the theme is essentially the same.

In the UK, two depressing statistics are: one, that about 25% of the population are smokers and two; that young girls are overtaking boys on the uptake of smoking. All this means that smoking is a major issue in pregnancy and childbirth. OK, the rate overall is falling (in 1974, 41% of women in UK smoked) but it is still depressingly high.

In the United States, just over 19% of all women smoke, that is 1 in 5. The rate is actually higher among young women. In 2002, about 1 in 9 women reported to smoke during pregnancy. The rate of smoking for teenage mothers was higher at 1 in 6.

Smoking among women in Southern European countries is much higher with France reporting figures of around 35%, with roughly 25% of pregnant women smoking. About a third of these give up during pregnancy.

In Australia, a report in 2005 showed that about 1 in 5 women smoke during pregnancy. Crucially, the differences by age and socio-economic status were stark. This report showed that over 40% of teenage mothers smoked during pregnancy compared to about 11% of those mothers aged 35 and over. Among Aboriginal women, the rate was 52%!

Smoking among women in developing countries is, mercifully, a lot lower. In some Sub-Saharan African countries, rates are around 1-2% and during pregnancy these drop to below 1%. In China, where smoking is a major health problem directly or indirectly killing over a million people annually; 6% of women smoked in 1999. That figure had worryingly risen to over 10% by 2008 and significantly, most of those taking up smoking are the young; those in the child-bearing age. The rate for men is much higher.

These are general facts in the public arena:

· That smoking is likely to cause fetal growth restriction in the womb (with all the spin-off consequences of this),

· That the baby of a smoking mother (or father) is more prone to cot death and

· That the child is several times more likely to suffer from glue-ear.

· There are other less well-known facts such as the increase in the likelihood of preterm labor, placental abruption and fetal death in the womb.

However independently minded a prospective mother might be; she will in most cases concede that pregnancy does bring with it an added responsibility on her. This is the well-being of another person. As such, pregnancy quite often turns out to be the time when the mother faces up to her lifestyle and examines whether she should continue smoking or not. Many women find this to be that elusive impetus they needed to quit smoking.

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