Agenda item

Stopping smoking during pregnancy is the single most important change a woman can make to ensure her pregnancy avoids unnecessary complications and improve the probability of her baby being born full term and healthy.

The national Tobacco Control Plan seeks to reduce maternal smoking in England to 6% or less by 2022. The aim of the Medway Maternal Smoking Strategy group is to reduce smoking at time of delivery (SATOD) prevalence in Medway to 6% or less by March 2022. This will be done by achieving a year on year reduction that will result in incremental improvements to our SATOD rate from our current prevalence of 18.6% in Q4 2016/17, to 6% by Q4 2021/22.

In addition to stating this ambition, the Maternal Smoking Strategy highlights the range of partnership work that needs to take place in order to achieve this ambitious target. The Board is asked to review and endorse the strategy and commit to supporting the strategy group over the next four years.

Discussion

The proposed draft Strategy sought to reduce the smoking rate amongst pregnant women in Medway, prevalence for which was high compared to averages. The Strategy would be joint between the Council, Medway Foundation Trust and Medway NHS Clinical Commissioning Group (CCG). The Action Plan that supported the Strategy included a number of interventions to facilitate delivery of the Strategy.

This document would be continually updated. The Strategy would ensure that healthcare professionals had the chance to discuss with their patients, the issues around smoking during pregnancy and the support available.

Providing quality support and raising awareness of additional support available, would be key to achieving the aim of reducing the prevalence of smoking at time of delivery (SATOD) in Medway to 6% or less by 2022.

A Board Member considered that the Strategy was a good starting point but felt that it needed to go further given that the prevalence of smoking in Medway was relatively high. Achievement of a 6% reduction in SATOD would require a change in culture and education as well as sustained funding. Joint working and engagement with the CCG, Healthwatch Medway and with the general public would also be important. The Member also felt that there was not enough discussion about what a ‘good’ pregnancy looked like and said that there was likely to be a link between smoking in pregnancy and consumption of alcohol in pregnancy.

Stop smoking messages needed to be carefully targeted and included as part of a wider public health discussion in order to avoid the perception that people were being told what to do. The average age of a woman giving birth for the first time had increased to the early 30’s. The Member considered that the increasing average age of new mothers needed to be taken into account as those who had been smoking for a lengthy period could find it harder to quit and may need to be targeted in a different way to younger mothers. Officers agreed that stop smoking messages needed to be communicated as part of wider healthy lifestyle messaging, but that it was also important that healthcare professionals had the confidence to engage with pregnant women and also with their families, the latter which a Member had raised as being an important consideration.

In response to Member concern that those who were smoking were often those least able to afford the financial cost, The Director of Public Health acknowledged that more disadvantaged people were more likely to smoke, and have more difficulty stopping. Midwives needed to be supported so that they had the confidence to have conversations about healthy lifestyles. The Director was due to be attending a Directors of Finance CCG meeting with representatives of the Medway and Kent CCGs. This meeting was due to discuss smoking cessation and the making available of additional NHS resources over and above existing Public Health funding.

A Board Member highlighted that Medway Maritime Hospital was now a smoke free site. An Action Group had been established, based at the hospital, to look at the issue of smoking during pregnancy. The group had initially been chaired by the Member before being taken forward directly by midwives, with engagement having taken place with pregnant women. The Chief Executive of Public Health England had recently visited Medway and considered it to be an excellent example of engagement in relation to smoking during pregnancy.

Decision

The Board reviewed and supported the Maternal Smoking Strategy and committed to supporting the Maternal Stop Smoking Strategy Group over the next four years.