Smoking by mothers 'kills 4,000 foetuses'

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MORE THAN 4,000 miscarriages of healthy foetuses happen each year because of maternal smoking during pregnancy, and up to 17,000 hospital admissions in the under-fives are due to inhalation of smoke from the cigarettes of parents or carers, the Royal College of Physicians believes.

The conclusion is given in a report that highlights the damage smoking inflicts on foetuses and babies. It says maternal smoking during pregnancy and infancy is 'the most important avoidable risk factor for infant death'.

More than a quarter of cot deaths, and about 400 deaths in very young babies each year, are linked with maternal smoking. Babies born to mothers who smoke also suffer physical and mental disadvantages which persist well into adulthood.

At 11, when all other factors are corrected, the children of smokers are smaller. By the age of 23, they have fewer academic qualifications than the offspring of non- smokers. The report says that children whose parents or carers smoke may inhale the equivalent of up to 150 cigarettes a year.

The working party reviewed more than 400 research papers and reports stretching over 20 years of investigations. Then they applied the international findings to British figures. The party included doctors expert in child health, public health and epidemiology and specialists in heart and chest medicine.

Dr Sarah Stewart-Brown, a consultant in public health medicine and a member of the party which compiled Smoking and the Young, called for an urgent 'rethink' on the education of mothers-to-be, and a better understanding of the 'addictive' quality of smoking. 'Trying to conquer an addiction at the same time as you are having a baby is perhaps too much to expect,' she said. Smoking among teenage girls, the mothers of the future, was on the increase.

One in three women smoke and of those only one in four abandons the habit during pregnancy.

Other studies show women are giving up smoking more slowly than men. While smoking among men dropped by a third between 1972 and 1986, among women it fell by less than a quarter to 31 per cent. While 18 per cent of 15 and 16-year-old boys smoke, the number among girls of the same age is 27 per cent.

Over 25 years smoking has fallen dramatically among men in the highest social classes but by a smaller proportion among women. There are concentrated groups of women smokers in professions such as nursing, teaching, social work and management.

The Royal College report is highly critical of the Government for 'aiding and abetting' the tobacco industry through voluntary agreements on cigarette advertising. The BBC is also attacked for allowing coverage of cigarette- sponsored sports.

On present trends, it is unlikely that government targets for smoking reduction of a third in men and women by 2000 will be met, the report said. A White Paper giving the targets, the Health of the Nation, is expected next week.

The report calls for a ban on all tobacco promotion, an increase in tobacco's price, action by retailers to stop children buying cigarettes, and a change in the law to make cigarette-buying illegal under 18.

Smoking and the young is available from the Royal College of Physicians, 11 St Andrew's Place, Regent's Park, London NW1 4LE, price pounds 10 plus pounds 1 p&p.