Impact of tobacco on reproductive and child health

(Wednesday, 11 Feb 2004, BMA Scotland)

The first report on the impact of tobacco on reproductive and child health is published by the BMA

Smoking damages almost all aspects of sexual, reproductive and child health according to a new report out today (11 February) by the BMA.

New calculations in the report estimate* that in the UK:

around 120,000 men aged 30-50 are impotent because of smoking
every year smoking is implicated in around 1,200 cases of malignant cervical cancer
smoking is linked to around 3-5,000 miscarriages every year

The report also concludes that:
women who smoke take longer to conceive: the chances of conception are reduced by up to 40% per cycle
men and women who smoke may have a poorer response to fertility treatment

Smoking and reproductive life � the impact of smoking on sexual, reproductive and child health is produced by the BMA's Board of Science, chaired by Sir David Carter former CMO of Scotland, and the Tobacco Control Resource Centre and is the first report of its kind.

The report states that smoking harms sexual and reproductive health in both men and women. Its damaging effects are seen throughout reproductive life � from puberty, through young adulthood and into middle age. Smoking can prevent people from having a family, and parental smoking can have long-term and serious consequences for child health. Exposure to second-hand smoke is a risk during pregnancy, and harms infants and children.

Women who smoke during pregnancy are three times more likely to have a low birth-weight baby. Low birth weight is closely linked to illness and death in infancy. Smoking during pregnancy also increases the risk of miscarriage, stillbirth and death of the newborn. New evidence that smoking may increase the risk of certain foetal malformations, such as cleft lip and palate, is presented. Smoking can also compromise breastfeeding: women who smoke produce less milk, of poorer quality.

Smoking and reproductive life also looks at the effects of passive smoking on reproductive and child health. Passive smoking can cause cot death, respiratory infection in children and the development of childhood asthma. There is substantial evidence that links passive smoking to reduced foetal growth and premature birth.

Dr John Garner, Chairman of the BMA Scottish Council said: "This report gives further evidence of the need for effective action on tobacco control from the Scottish Executive.

"Despite the Executive's Tobacco Action Plan (published January 2004) stating that smoking during pregnancy is the single largest preventable cause of disease and death to foetus and infants, their target rates to reduce smoking amongst pregnant women remain the same as previously stated."

Dr Sinead Jones, Director of the BMA's Tobacco Control Resource Centre and author of the report said: "Smoking has a profound impact on every aspect of reproductive life, from puberty through middle-age and beyond. It affects not just our health, but the health of those dearest to us. And, sadly, its lethal legacy reaches beyond this generation, into the next".

Dr Vivienne Nathanson, the BMA's Head of Science and Ethics, said today: "The sheer scale of damage that smoking causes to reproductive and child health is shocking. Women are generally aware that they should not smoke while pregnant but the message needs to be far stronger. Men and women who think they might want children one day should bin cigarettes."

She added: "And we're not just talking about having children. Women who want to protect themselves from cervical cancer should give up smoking. Men who want to continue to enjoy sex should forget about lighting up given the strong evidence to that smoking is a major cause of male sexual impotence."

The report also highlights the fact that support from family and friends can help smokers succeed in quitting. But while one in three pregnant smokers succeeds in quitting, just one in twenty of their partners stops too.

Highlighting the impact of men's smoking on the family, Dr Nathanson stated: "Reproductive health is not just a concern for women. Men also need to accept the challenge to quit smoking to improve their reproductive health, support their partners, and protect their children".

Exposure to second-hand smoke in childhood is associated with increased hospitalisation. It is estimated that each year, more than 17,000 children under five years old are admitted to UK hospitals because of respiratory illness caused by exposure to other people's cigarette smoke. The costs of children's medical care from exposure to second-hand smoke in Great Britain have been estimated at �167 million at 1997 prices.

The total costs of smoking-related reproductive ill health in the UK are not known. However, smoking-related illnesses have been estimated to cost NHS Scotland at least �200 million each year (UK figures are �1.5 billion each year).
 

The report makes a number of recommendations to tackle the problem. These include:

• Pregnant workers who cannot be ensured protection from second-hand smoke should be entitled to leave on full pay for the duration of their pregnancy [EU Directive 92/85/EEC].

• Pictorial health warnings should be added to tobacco, and should reflect risks to reproductive life.

• Promotion of tobacco through channels that appeal to younger people � particularly films, sport, television, fashion and role models - remains a grave concern. Media figures, editors, producers and celebrities should not promote or glamorise smoking.

• Government targets to reduce overall smoking rates should be more ambitious.

• The introduction of legislation to make public places smoke-free.

The Smoking and Reproductive Life report is available at : http://www.bma.org.uk/ap.nsf/Content/SmokingReproductiveLife