New research highlights the potential to reduce the rates of premature birth and stillbirth in New South Wales (NSW), Australia, using smoking cessation campaigns that outline the benefits of not smoking during pregnancy.

Research has already shown that smoking during pregnancy increases the risk of stillbirth, premature birth or having a baby below a healthy birthweight. Babies are also more at risk of infections and longer-term health problems like asthma.

In New South Wales (NSW), the overall smoking rate during pregnancy has decreased over the last 20 years, which is a great achievement. However, despite this reduction, around 8-9% of the population continue to smoke during pregnancy, which is still too high. This highlights the need for continued focus on smoking in pregnancy.  

Researchers from Women and Babies Research at the University of Sydney partnered with policymakers from the NSW Ministry of Health to ensure that their new research study produced maximum impact on public health. Given the stigma sometimes associated with smoking during pregnancy, the issue was positively framed by presenting the benefits of not smoking as a more effective way to influence changes in behaviour.

To achieve this, researchers analysed hospital admissions and birth records for all births in NSW over a 5-year period from 2012-2016. They examined the difference in adverse outcomes between babies born to mothers who did not smoke during pregnancy and those who did smoke. Because a similar study was recently conducted with Aboriginal women*, this study focused on non-Aboriginal women only.

The team found that around 6% of premature births (before 37 weeks) and more than 10% of babies born below a healthy birthweight, could be prevented if mothers were non-smokers during pregnancy. Babies born to mothers who did not smoke during pregnancy were also less likely to be stillborn, to die within 28 days of birth, or to experience severe health outcomes.

Dr Patterson, a senior researcher on the study said “Around 8,000 babies each year are exposed to maternal smoking before they are born. We expect our research will inform future interventions and highlight the significant benefits of not smoking for women and their babies.”

The results of this research will be used to strengthen current efforts to reduce smoking in pregnancy throughout NSW.

Dr Ioannides, a co-author and medical advisor in the NSW Ministry of Health added that “Reducing the number of women who smoke during pregnancy is a key focus of the NSW Ministry of Health. This study helps to quantify the benefits of not smoking during pregnancy, which has important implications for future NSW Health policy.

Dr Patterson concluded that “This is a good example of researchers collaborating with policymakers to address important hurdles in public health messaging leading to improved health outcomes.”


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Dr Jill Patterson, University of Sydney Northern Clinical School, Women and Babies Research

Patterson, J., Cashmore, A., Ioannides, S., Milat, A., Nippita, T., Morris, J. and Torvaldsen, S. (2021) “Benefits of not smoking during pregnancy for non-Aboriginal women and their babies in New South Wales, Australia: a record linkage study”, International Journal of Population Data Science, 6(1). doi: 10.23889/ijpds.v6i1.1699.