Tobacco

Smoking can have devastating consequences for expectant mothers and their babies. Smoking during pregnancy increases the risk of stillbirth, and babies born to mothers who smoke are more likely to be born underdeveloped and in poor health. Maternal smoking after birth is associated with a threefold increase in the risk of sudden infant death. Smoking during pregnancy is also a major health inequality, with prevalence varying significantly across communities and social groups. Smoking prevalence among pregnant women in more disadvantaged groups and those aged under 20 remains considerably higher than in older and more affluent groups. Mothers in routine and manual occupations are five times more likely to have smoked throughout pregnancy compared to women in managerial and professional occupations, meaning those from lower socioeconomic groups are at a much greater risk of complications during and after pregnancy.

Children who grow up with a smoking parent are also more likely to become smokers themselves, further perpetuating the cycle of inequality and affecting their life chances. Second-hand smoking increases a child’s risk of cot death, glue ear, asthma, and other respiratory disorders in later life and leads to over 300,000 UK GP consultations and about 9,500 hospital admissions every year (in addition to costing the NHS about £23.3 million annually). In the UK, around 2 million children are estimated to be regularly exposed to second-hand smoke in the home, more than any other environment. In 2021, a little over half (52%) of pupils reported having some level of exposure to second-hand smoke with 48% experiencing secondhand smoke in the home (theirs or others’). About one in ten (11%) of all pupils were exposed to second-hand smoke in the home every day or most days. Disadvantaged children are more likely to be exposed to second-hand smoke in the home, exacerbating inequalities and transmitting them across generations by increasing the chances of children growing up to smoke. A 2019 ASH and YouGov survey found that 20% of people in social grade E say that someone smokes in the home most days versus only 8% of people from social grade AB. Second-hand smoke exposure is also much higher in social housing, where adult smoking rates are disproportionately high and smoking related inequalities concentrated.

The Office for Health Inequalities and Disparities Local Tobacco Control Profiles for England show that as the severity of mental health conditions increases, smoking prevalence is higher. In 2014/15, prevalence in all adults (aged 18+) was 16.4% and prevalence in adults living with anxiety or depression was 28.0%, a long-term mental health condition was 34.0% and a serious mental illness was 40.5%. Even common mental health conditions, such as anxiety and depression, are associated with a greater likelihood of smoking and of being highly dependent. People with poor mental health die on average 10 to 20 years earlier than the general population, and smoking is the biggest cause of this life expectancy gap.

In general, men are more likely to smoke than women. Since 2010, smoking has become less common across all age groups. Smoking continues to be lowest among people aged 60 and over. Although they are more likely than younger people to have ever been smokers, they are also more likely to have stopped smoking.