Over the last ten years, England has made significant progress in reducing the number of pregnant women who smoke. However, health experts warn that if financial cuts to the National Health Service (NHS) persist, this hard-won achievement may be lost. 

This risk was highlighted in a recent publication in the British Medical Journal (BMJ). Prof. Caitlin Notley, a specialist in addiction studies at the University of East Anglia, contributed to the writing. According to the report, smoking rates during pregnancy have dropped dramatically, from 11.7% in 2014-15 to just 5.9% by the third quarter of 2024-25. That is about a 50% drop. 

Much of this success has occurred in the previous five years, with the NHS introducing professional quit-smoking counsellors to maternity facilities in 2020. These counsellors work directly with pregnant women to help them quit smoking, which has been shown to be both beneficial and life-saving. 

Prof. Notley explains, "This decline did not occur by happenstance. It is the product of hard work by healthcare workers who assist women throughout their pregnancy. However, a troubling trend is emerging: a reduction in resources, heightened pressure, and a potential loss of this success. 

Smoking while pregnant increases the risk of miscarriage, stillbirth, early birth, low birth weight, and sudden infant death syndrome (SIDS). It also has long-term consequences for a baby's health, such as an increased risk of asthma and learning difficulties. 

That is why experts believe the recent decrease in smoking is a significant public health victory. 

However, there is a catch. This drop has not been uniform across all groups. Pregnant women in lower-income communities are still more prone to smoke. According to Prof Notley, these women frequently suffer higher levels of stress and have fewer resources, making quitting more challenging. "We need smart, focused support for the women who need it most," she told me. 

The concern is not purely theoretical. Members of the Smoking in Pregnancy Challenge Group, a coalition of health institutions, report that certain NHS trusts and mental health providers have already reduced or eliminated smoking support programs. This follows funding cuts for Integrated Care Boards (ICBs), which govern local NHS services. 

Prof. Linda Bauld, co-chair of the panel and a respected public health specialist, cautions: "The evidence is there. Helping women quit smoking during pregnancy has saved lives. If funding is reduced, smoking rates may rise again, with catastrophic effects for both parents and children. 

Dr Clea Harmer, who co-chairs the panel and runs the stillbirth charity Sands, agrees. "If the goal is a smoke-free generation, now is not the time to cut back," she cautioned. "We should be going faster, not slower." 

John Waldron, policy manager of Action on Smoking and Health, stressed that the Labour Party's vow to provide stop-smoking assistance in all hospitals must be kept. "These services don't just help mothers — they protect babies and save the NHS money in the long run." 

According to studies, smoking during pregnancy is the single most modifiable risk factor for poor delivery outcomes. That means it's one of the few hazards that doctors can try to mitigate — but only if they have the necessary tools and resources. 

Quitting smoking is particularly difficult during pregnancy due to stress, addiction, and social pressures. That is why individualised care, including regular check-ins, nicotine replacement treatment, and emotional support, is so important. 

The UK government has already committed to having England smoke-free by 2030, with less than 5% of the population smoking. While overall adult smoking rates have decreased, achieving this goal without focused assistance for pregnant women, particularly in disadvantaged communities, may be impossible. 

As the NHS is under increasing pressure to cut costs, many public health initiatives are in jeopardy. However, experts argue that eliminating stop-smoking services for pregnant women is a short-sighted decision that could wind up costing more – not only money, but lives. 

"Every child deserves a healthy start," stated Prof. Notley. "And every mother deserves help to quit." We can't afford to turn back now."