Analysis of the Statistics on Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016) by the Health & Social Care Information Centre (HSCIC) shows that London mums-to-be have the lowest rate of smoking in the country.

With just 4.9% of pregnant women identified as smokers at time of delivery, the UK capital didn’t only reach the national ambition of 11% but also set an example for the rest of England to follow. While all London boroughs reached the national target of 11%, a closer look at smoking prevalence among pregnant women at time of delivery reveals a major variance.

Borough Breakdown

With just 1.5% of expectant women smoking at time of delivery, Westminster has the lowest rate of smoking mums-to-be not only in London but the entire country. With 8.6% of pregnant women admitting to smoking at time of delivery, the boroughs of Greenwich, and Barking and Dagenham have the highest smoking prevalence in the UK capital. This is below the national average of 10.6% as well as below the rate of smoking mums-to-be in a number of English cities but it’s nearly six times higher than in Westminster.  

Smoking Prevalence Among London Mums-To-Be at Time of Delivery

Data Source: Statistics on Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016), HSCIC

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The Role of Economic Factor in Smoking Rates

Trying to explain the reasons for the variance in smoking prevalence among pregnant women between different London boroughs, we looked at different factors including income and (un)employment status which have been shown to have had a major influence on the overall smoking rates among adults aged 18 or above. The statistics on Average Income of Tax Payers, Borough reveal that Westminster taxpayers have the highest income (£36,400, Median). Residents of the Borough of Barking and Dagenham, on the other hand, were found to have the lowest Median income (£21,000). A similar pattern was also observed when comparing other boroughs with high and low smoking rates among pregnant women.

A very familiar pattern soon appeared when we looked at the unemployment ratios by boroughs. At 9.8%, the unemployment level in the Borough of Barking and Dagenham is twice as high as in Westminster (4.9%). High unemployment rates were also found in other “high-smoking boroughs” including Greenwich (8.1%) and Croydon (7.3%). In contrast, boroughs with low smoking prevalence among expectant women tend to have low unemployment levels. Examples include Richmond upon Thames (3.8%), Barnet (5.2%), and Hammersmith and Fulham (5.3%), to mention only a few.

To confirm the theory that mums-to-be who live in low-income, high-unemployment boroughs are more likely to smoke, we also looked at the overall smoking rates among adults aged 18 or above by boroughs. Again, Barking and Dagenham was among the boroughs with the highest smoking prevalence (21.7%). However, Westminster was also found to have a smoking prevalence of 20%. Unusually high smoking rates were also observed in the Borough of Hammersmith and Fulham (22.2%) even though it has one of the lowest smoking rates among expectant women. The evidence is thus too inconclusive to explain the rates of smoking among London mums-to-be by the economic factor alone although there are strong indications that it plays an important role.

Comparison to Smoking Rates at the First Midwife Appointment Very Concerning

Data source: Statistics on Women’s Smoking Status at Time of Delivery: England (April 2015 to March 2016), HSCIC; Maternity Services Reports (April 2015 to March 2016), NHS Digital

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While London is setting a great example for the rest of England when it comes to smoking prevalence among pregnant women at time of delivery, comparison to smoking rates at the first midwife appointment is very concerning. At 5.1%, London mums-to-be have the lowest rate of smoking in the country – more than twice as low as their counterparts in Midlands, and South and East of England, and more than three times as low as those in North of England. But considering that 4.9% of pregnant women are recorded as smokers at time of delivery, it means that the majority of London mums-to-be continue to smoke throughout their pregnancy.

Chris Polenski
Chris Polenski