Smoking is the single most important modifiable risk factor in pregnancy, accounting for one in 14 preterm deaths and one in three cases of SUDI. Not only does smoking increase the risk of infant mortality, it also accounts for one in five cases of low birthweight in babies carried to full term, and one in 12 premature births (again leading to an increased risk of low birthweight). 1 Overall, it has been estimated that smoking during pregnancy increases the risk of infant mortality by 40%. 2

Infants of parents who smoke are more likely to suffer from serious respiratory infections, symptoms of asthma and problems of the ear, nose and throat. Looking beyond infancy, smoking during pregnancy is associated with an increased risk of: 3

  • wheezy illnesses in later childhood
  • psychological problems such as inattention, hyperactivity, disruptive and negative behaviour
  • lower educational performance.

Parental (particularly maternal) smoking is also a strong and significant determinant of the risk of smoking uptake by children and young people, and hence propagates intergenerational poor health outcomes. 4

Smoking during pregnancy is strongly associated with a number of underlying factors, including age and socio-economic position. Teenage mothers are six times more likely than mothers aged 30-34 to smoke. Pregnant women from unskilled occupations are five times more likely to smoke than professionals. 5


  1. “,” Public Health England, 2015. [Online]. Available: [Accessed May 2016].
  2. Department of Health, “Review of the Health Inequalities Infant Mortality PSA Target,” 2007.
  3. “Smoking: stopping in pregnancy and after childbirth [PH26],” National Institute for Health and Care Excellence, 2010. [Online]. Available: [Accessed May 2016].
  4. J. Leonardi-Bee, M. Jere and J. Britton, “Exposure to parental and sibling smoking and the risk of smoking uptake in childhood and adolescence: a systematic review and meta-analysis,” Thorax, vol. 66, pp. 847-855, 2011.
  5. “,” Public Health England, 2015. [Online]. Available: [Accessed May 2016].