Towards a Smokefree Generation 6th December 2017

The Smoking in Pregnancy Challenge Group

2015 priority recommendations 1. A new national ambition to reduce smoking in pregnancy to less than 6% by 2020 Green 2. National leadership to provide clarity about the roles local authorities and local NHS organisations and others should play in tackling smoking in pregnancy. Amber 3. A robust and consistent national data collection system implemented across the country 4. Training of professionals to tackle smoking in pregnancy must be nationally mandated. 5. Opt-out referral of all pregnant women who smoke to specialist services must become standard practice across the country. 6. Public Health England and NHS England should publish a shared national communications strategy on tackling smoking among pregnant women and their families 7. Research funders should continue to support high quality studies to help inform policy and practice on the best ways to help women to stop smoking in pregnancy. We have made a lot of progress over the last few years. Rates of SATOD have been declining and there has been action by Government nationally and locally. This shows some of the priority recommendations the Challenge Group made in 2015 and our initial assessment of progress towards them. We will be publishing a more detailed review in the New Year but our initial assessment is that it is clear progress has been made although there continues to be room for improvement.

Tobacco Control Plan New Government target: 6% by 2022 Commitments to change the Maternity Services Dataset to include CO Monitoring Commitment to continue to implement NICE Guidance BUT… How can we achieve consistency across the country? Are further actions needed? Our report next year will be in the context of the new commitments that Government has made. The TC Plan was published in July and it sets a new ambitious target to further reduce rates of smoking in pregnancy. However, it is relatively short on actions with a clear commitment to improve the Maternity Services Dataset and continued actions to support local implementation of NICE guidance but little else. Today we hope to explore some key questions around how the Plan will be implemented and consider what else might need to be done to achieve the Government’s target.

If we achieve 6% target… Around 28,500 more smokefree births by 2022 Major contribution to reducing rates of stillbirth and neonatal deaths and other poor birth outcomes Contribute to reducing the inequalities in poor birth outcomes Achieving the Government’s target brings great prizes and without significant rate of decline in smoking during pregnancy they are unlikely to achieve other goals such as halving the rate of stillbirth and neonatal death by 2030.

More progress is needed to achieve 2022 target Achieving 2022 target of 6% will require a near doubling of the current rate of decline nationally The first quarter of 2017/18 shows no decline But achieving the target will require a near doubling of the rate of progress in reducing rates that we have seen in recent years. We need to see an annual rate of decline of 0.9% - however, the last quarter of SATOD data showed no decline.

We know there are big geographic variations in the rate of smoking at time of delivery and these are driven by local inequalities in smoking rates to a large extent.

A majority of CCGs are not achieving rate of decline needed What concerns us, however, is the unwarranted variation in local performance to reduce rates of smoking at time of delivery. In the last two years a minority of areas have achieved the rate of decline needed to achieve the Government’s target.

Today… Fill in feedback forms and tell us: The key challenges and opportunities around reducing rates of smoking in pregnancy further What the priorities should be for national action by the Challenge Group and by Government What would make the most difference to rates of smoking in pregnancy in your area