Friday, September 11, 1998 Published at 03:33 GMT 04:33 UK
Pregnant women fail to quit smoking
Smoking during pregnancy poses many health risks
The last Conservative Government set a target that by the year 2000 one-third of women who smoke should stop at the start of their pregnancy.
But research by the Health Education Authority has found that the target - set in 1992 as part of the Health of the Nation initiative - has proved to be too optimistic.
Dr Lesley Owen and her team found that the prevalence of smoking in pregnant women was much the same in 1997 as in 1992.
The highest rates of smoking during pregnancy are found among younger women aged between 16 and 24 who are unemployed or manual workers. The rate of smoking in this group has risen from 41% in 1992 to 45% in 1997.
The researchers also found that only one in 10 women who smoked gave up immediately before they became pregnant.
Writing in the British Medical Journal, they conclude that: "Current practice to reduce smoking during pregnancy is either not working or lacks sufficient investment and prioritisation to be effective."
Advice not forthcoming
Dr Owen said the research found that less than half the women were given advice on giving up smoking by a health professional.
She said: "Smoking needs to be given a greater priority in the primary care field. Every opportunity should be taken to bring the subject up, and every opportunity taken to help women give up.
"When pregnant women do not receive any advice on smoking they assume it is okay to carry on. They take the attitude that if they are not going to tell me it is dangerous then it can't be that serious."
Dr Owen said primary care workers needed more training in how to help women give up smoking. She accepted that staff often worked under enormous pressure and with limited resources.
"Smoking is an addiction and needs to be handled sensitively. Trying to give up smoking is a difficult task at the best of times, and during pregnancy when there are a whole host of stresses it can be even harder," she said.
Clive Bates, director of pressure group Action on Smoking and Health (ASH), said: "The NHS basically fails to tackle smoking during pregnancy. Like the whole NHS approach to smoking, it is ad hoc, patchy and based on the enthusiasm or the indifference of the people involved."
ASH said the government should give encouragement, advice, and prescriptions of nicotine replacement therapy for women who smoke during pregnancy.
Mary Newbone, director of policy for the National Childbirth Trust, warned that smoking was a complex problem, and that it would be wrong to blame women for refusing to give up the habit.
Ms Newbone said: "Typically it is socially disadvantaged women who have very limited choices in their life who smoke. They see it as a source of pleasure and a way to relieve stress.
"The approach should not be to blame women for smoking during pregnancy, but to look at ways to try to alleviate the stress in their lives so they are more able to give up."
Seven surveys have been carried out by the Health Education Authority between 1992-1997, involving between 600 and 1,000 women.