Inequalities in smoking among pregnant women in North West London

Abstract

Background London has the lowest smoking prevalence among pregnant women in England. However, it was unclear whether the low overall prevalence masked inequalities. This study investigated the prevalence of smoking among pregnant women in North West London stratified by ethnicity and deprivation. Methods Data regarding smoking status, ethnicity and deprivation were extracted from electronic health records collected by maternity services at Imperial Healthcare NHS Trust between January 2020 and August 2022. Results A total of 25 231 women were included in this study. At the time of booking of antenatal care (mean of 12 weeks), 4% of women were current smokers, 17% were ex-smokers and 78% never smokers. There were marked differences in the smoking prevalence between ethnic groups. Women of Mixed—White and Black Caribbean ethnicity and White Irish women had the highest prevalence of smoking (12 and 9%, respectively). There was an over 4-fold increase in the prevalence of smoking between the most and the least deprived groups (5.6 versus 1.3%). Conclusions Even in a population with an overall low prevalence of smoking in pregnancy, women experiencing deprivation and from certain ethnic backgrounds have a high smoking prevalence and hence are the most likely to benefit from smoking cessation interventions.

Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses

“…A priori, we expected residual confounding from unobserved childhood poverty and neighborhood factors, given prior evidence on the topic [ 19 , 46 , 47 ] and the unavailability of childhood variables in the UK Biobank. However, evidence suggests that maternal smoking during pregnancy is a strong proxy for childhood socioeconomic status [ 81 – 85 ] and has been used as such in prior work [ 42 ]. Thus, we used the maternal smoking coefficient as a plausible estimate of the association that may be expected between an unmeasured childhood confounder and each outcome, conditional on observed covariates and childhood maltreatment.…”

Unequal Care: Examining the intersection of multifactorial factors contributing to suboptimal perinatal outcomes: A scoping review and implications for perinatal services in the UK

“…We have lesser understanding of the impact of smoking in ethnic minorities on outcomes in the UK; although there is evidence that smoking rates are overall higher in sub-categories of ethnic minority (highest in Eastern European) 26 . In North West London between 2020-2022 27 ,white Irish women, and women of mixed white and black Caribbean ethnic group had the highest prevalence of smoking in relation to pregnancy. There was also a four-fold increase between smoking rates in pregnancy in the worst compared to least deprived groups 28 .…”