The Life Cycle of the Welsh Smoker Elen de Lacy Research and Policy Analyst ASH Wales elen@ashwales.co.uk

Introducing Griff

My Mam’s smoking… 37% of Welsh mothers smoke at some stage during their pregnancy More than 1 in 5 smoke through out pregnancy The proportion of babies born with a low birthweight is highest in Merthyr Tydfil and Blaenau Gwent.

My Mam’s smoking Substantially increased risk of spontaneous abortion and premature birth. Maternal cigarette smoking and low birth weight—a dose-dependent relationship Maternal cigarette smoking is unequivocally the largest and most important known, modifiable risk factor for low birth weight (and infant death)

My Mam’s smoking Active maternal smoking causes up to about 5,000 miscarriages, 300 perinatal deaths, and 2,200 premature singleton births in the UK each year. Passive exposure of the foetus to active maternal smoking also causes around 19,000 babies to be born with low birth weight in the UK each year. Maternal passive smoking may reduce fertility, increase foetal and perinatal mortality, and increase the risk of some congenital abnormalities.  

Towards smoke free pregnancies… It doesn’t have to be like this Towards smoke free pregnancies…

What do we know about smoking in pregnancy? Mothers smoking during pregnancy, by country (2005) Source: Infant Feeding Survey What other information do we have? What information would it be useful to have?

Is this acceptable? If we don’t do anything different, what is the likely direction of travel for smoking in pregnancy rates? Why are things the way they are? What are we doing, and what more could be done? Who needs to be involved?

Low Birth Weight Babies Smoking nearly doubles the risk of low birth weight Increases the risk of premature birth LBW and pre-term infants have increased risks immediately including Respiratory Distress Syndrome, Intracranial Haemorrhage, Patent ductus arteriosus ,Necrotizing enterocolitis and Retinopathy of prematurity

Low Birth Weight Babies Increased risk of: SIDS Asthma Glue ear Cerebral palsy Learning difficulties Long term morbidity including heart disease, diabetes and obesity

Low Birth Weight Babies LBW is the main reason babies die in the first year of life.

Welcoming Griff

Griff: A Smoking Toddler Over 300,000 UK GP admissions and about 9,500 hospital admissions annually from ETS ETS causes around 40 SID’s in the UK annually A poll for SmokeFree London found that only 3% of parents knew that cot death could result from passive smoking and only 1% identified glue ear as an outcome.

Smoking – It’s the Norm Three out of four children are aware of cigarettes before they reach the age of five whether or not the parents smoke. Children growing up with parents or siblings who smoke are 90% more likely to become smokers themselves. Teenagers overestimate how many people smoke

Griff – The Tweeny Surveyed 109 young smokers aged 11-17 in Valleys between 1 June and 30 June 2008. 28 males and 81 females made up the 109 children The average age they started to smoke is 11.2 7 was reported as the youngest age at which smoking commenced – still in infant school!

Griff – The Tweeny Children who smoke are two to six times more susceptible to coughs and increased phlegm, wheeziness and shortness of breath than those who do not smoke. Smoking impairs lung growth and initiates premature lung function decline which may lead to an increased risk of chronic obstructive lung disease later in life. The earlier children become regular smokers and persist in the habit as adults, the greater the risk of lung cancer or heart disease.

Griff – The Teenager There is a strong association between smoking and other substance use. Higher rates of truancy.

Getting Fags is Easy The average amount of cigarettes smoked each week is 45 and in some cases are smoking up to 200 cigarettes per week 78% of those surveyed can buy cigarettes in local shops 20% of those surveyed can buy cigarettes from supermarkets 80% can buy cigarettes off friends and family

Getting Fags is Easy 1 in 5 can get cigarettes from vending machines 8% can buy cigarettes from ice cream vans and burger vans and private dwellings 81% can access SINGLE CIGARETTES through friends, family and in the school setting 7% can buy SINGLE CIGARETTES from shops or mobile vans – the sale of single cigarettes was outlawed in the UK in 1991.

Towards smoke free teenagers … It doesn’t have to be like this Towards smoke free teenagers …

What do we know about teenage smoking? What other information do we have? What information would it be useful to have?

Is this acceptable? If we don’t do anything different, what is the likely direction of travel for teenage smoking? Why are things the way they are? What are we doing, and what more could be done? Who needs to be involved?

Griff – The Young Man Manual Labourer Social Class D or E Prevalence rates of nearly 1 in 2 Highly addicted may have started to think about quitting

It doesn’t have to be like this Towards smoke free adults …

What do we know about adult smokers? 25% men and 23% women reported that they smoked daily or occasionally (WHS, 2008) What other information do we have? What information would it be useful to have?

Adult current smokers by Local Authority, age standardised, Wales: 2003/04 to 2008 Data source: PHW Observatory from WAG (Welsh Health Survey 2008) 28 23 24 27 25 Isle of Anglesey 31 29 24 22 27 25 Gwynedd 28 23 27 25 24 Conwy 28 26 25 24 27 Denbighshire 25 24 26 27 Flintshire 26 28 23 27 24 25 Wrexham 2003/04 & 2004/05 2004/05 & 2005/06 2007 & 2008 2003/04 & 2004/05 2005/06 & 2007 2004/05 & 2005/06 2005/06 & 2007 2007 & 2008

Is this acceptable? If we don’t do anything different, what is the likely direction of travel for adults who smoke? Why are things the way they are? What are we doing, and what more could be done? Who needs to be involved?

References Smoking in Wales 2007: current facts Infant feeding survey 2005 RCP 2010. Passive smoking and children Welsh Health Survey 2008. Statistics for Wales Ffaith Youth Survey of young smokers aged 11-17. ASH Wales HBSC 2005/2006 Survey Cancer in Wales, 1992-2006:A Comprehensive Report. Welsh Cancer Intelligence and Surveillance Unit

Contact elen@ashwales.co.uk www.ashwales.co.uk