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No amount of smoking is safe during any stage of pregnancy, study finds
Smoking even one or two cigarettes a day before or during pregnancy can lead to serious health problems for newborns, according to a new analysis of more than 12 million families.
Globally, an estimated 1.7 per cent of pregnant women smoke, though that rate is 8.1 per cent in Europe and 5.9 per cent in the Americas. Smoking during pregnancy can negatively affect the newborn’s health, increasing their risk of preterm birth, low birth weight, restricted infant growth, and death.
In the study, which was published in the Journal of Epidemiology & Community Health, researchers analysed the relationship between smoking and major neonatal health complications such as needing assisted ventilation immediately after birth, being admitted to the neonatal intensive care unit (NICU) with ventilation, suspected sepsis, seizures, or neurological dysfunction.
Overall, about 9.5 per cent of babies experienced these issues. But they were 27 per cent more likely to have several of these complications if their mother smoked before pregnancy, and 31 per cent more likely if she smoked at any point during pregnancy, researchers found.
While researchers have long known about the poor outcomes tied to smoking during pregnancy, the new study indicates that even light smoking is unsafe, including in the months before pregnancy.
Neonatal outcomes were worse among those who smoked later into their pregnancies, the study found, but women who stopped smoking during pregnancy were still at a higher risk of poor neonatal outcomes compared with those who didn’t smoke at all.
“It's quite clear that cutting down, particularly during pregnancy, isn't enough,” said Caitlin Notley, who leads the addiction research group at the University of East Anglia in England, emphasising the need for “complete cessation” of smoking to protect infant health.
Pregnant women may find it harder to quit smoking because nicotine metabolism speeds up during pregnancy, meaning the body absorbs it more quickly, Notley said.
She said pregnant women trying to quit can try nicotine replacement therapies, such as nicotine gum, and opt for a higher dose if they find themselves still turning to cigarettes.
They can also try replacing traditional cigarettes with e-cigarettes, which may contain nicotine but no tobacco. Research is mixed on the effects of vaping on pregnancy outcomes. “It's a harm reduction approach of doing anything you can, basically, to support women to quit smoking,” Notley said.
Source: Euro News, 21 August 2024
See also: Maternal cigarette smoking before or during pregnancy increases the risk of severe neonatal morbidity after delivery: a nationwide population-based retrospective cohort study
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Adults wanting to quit smoking offered vaping kit
Adults in Bath and north east Somerset wishing to stop smoking will be offered a free vaping kit in exchange for handing in cigarettes.
The vaping kit will provide a month’s worth of e-liquids and a rechargeable vape. This initiative is part of the national Swap to Stop campaign which aims to cut smoking rates and improve the country’s health. First launched in April 2023, the campaign also intends to support the government in its goal to be smoke-free by 2030.
Becky Reynolds is director of public health for Bath & North East Somerset (B&NES) Council. She said: “There is strong evidence that vaping helps people to quit smoking and it’s less harmful than smoking. We are really pleased to be part of the national Swap to Stop programme in B&NES which means local smokers have an opportunity to try vaping at no cost to themselves.”
“We know how difficult it is to quit smoking and most smokers will have tried many times. Vaping is currently the most popular and most effective way to quit, so I encourage smokers in B&NES to take up this great offer.”
Source: Dentistry, 20 August 2024
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Targets ‘too constrictive’ as health expectancy gap widens
An NHS Confederation and Institute for Public Policy Research report published today shows the gap in health life expectancy – the number of years a person can expect to live in full health – has now grown to more than 20 years between local authorities across the UK.
System leaders told the report, which has been shared with HSJ, that national targets for ICSs too focused on acute rather than preventive outcomes are “constricting change” around improving health expectancy.
The report adds that a “smaller set of targets may be beneficial” to tackle the widening health expectancy gap between local areas.
It says: “Despite rhetoric on subsidiarity, local systems are still subject to a proliferation of targets. In turn, those targets tend to be focused on acute rather than preventative outcomes, constricting change.”
The new analysis, between 2018 and 2020, shows that men are expected to live healthily for 74.65 years in Rutland, the highest, compared to 53.49 in Blackpool, the lowest – a gap of 21.16 years. For women, this extends to 23.45 years: 77.49 years in Orkney Islands but only 54.04 in North Ayrshire.
The report engaged with four integrated care systems – West Yorkshire, North East London, Sussex and Coventry and Warwickshire – and the Hywel Dda University Health Board in Wales. It found that health inequalities are “highly localised” meaning that systems are key to progress.
However, it argued that ICS long-term working can be “blown off course by what politicians see as burning priorities”. This is usually waiting lists and emergency department performance “rather than population health outcomes that take time to change and deliver prosperity”.
“High turnover of health secretaries, short-termism in Treasury and the politicisation of the NHS are all challenges here. Providing long-term funding, space to experiment and political acknowledgement that real change takes time would be useful,” the report continued.
ICPs – with their ability to take a “holistic view” across different places and organisations – are also key to ensuring local work around health inequalities is linked and long term, it argued. But this requires “both resource and purpose”.
Source: HSJ, 16 August 2024
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Opinion: Bad news, red wine drinkers: alcohol is only ever bad for your health
Writing in the Guardian, Devi Sridhar, chair of global public health at the University of Edinburgh, discusses the latest evidence on the health harms of consuming alcohol.
Sridhar discusses the latest evidence on consuming alcohol, noting that in 2023 the World Health Organisation issued a statement saying that there was no safe level of drinking for health. Sridhar quotes a WHO official saying “the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is”.
However, despite this statement from the WHO there has been mixed approaches to alcohol in public policy since. Sridhar compares Canadian recommendations which state that abstinence is the only risk free approach, with four units a week being low risk, to the NHS which says no more than 14 units a week will keep you in the low risk category.
Sridhar goes on to address the notion that a glass of red wine a day could have health benefits, a claim based on a studies of the Mediterranean diet from two decades ago. Sridhar points out that some of the studies which found an associated benefit of red wine on health didn’t control for the fact red wine drinkers tended to be socioeconomically well off and have better all round diets. Since these initial studies evidence is increasingly showing that even one glass of red wine a day increases risk of high blood pressure.
Further, the alcohol industry has been selectively funding studies, in what Sidhar calls a tactic “famously used by the tobacco industry”. However, large scale epidemiological studies show a consensus that alcohol is bad for our bodies. Sridhar argues that this should inform government policies such as health warnings on alcohol labels, bans on multi buy promotions, restrictions on marketing and advertising and greater awareness of the health risks of drinking.
Source: The Guardian, 20 August 2024
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.
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