Smoking during pregnancy – need for consistent Public Health data in Australia

Abstract

Maternal smoking remains one of the most common preventable causes of infant morbidity and mortality. In addition, pregnancy is a natural window for smoking cessation, and this has led to the suggestion that support for smoking cessation and relapse prevention needs to be as routine in antenatal care as the measurement of blood pressure. Quality Australian data documenting rates of tobacco consumption by women during various stages of pregnancy are not currently available. While there is a specification for perinatal data elements for mandatory collection and reporting at a national level, the Perinatal Minimum Data Set (NMDS) has no data element for smoking during pregnancy and there is no national agreement on collection of data on smoking during pregnancy. In Australia, five jurisdictions collect data on smoking during pregnancy; however, the definitions they use differ. The Australian Capital Territory and New South Wales use two questions – (1) did the mother smoke during pregnancy; (2) average number of cigarettes smoked per day during the second half of the pregnancy. Western Australia asks whether the mother smoked during pregnancy. South Australia collects data on – (1) smoking status at the first antenatal visit; (2) average number of tobacco cigarettes smoked per day in the second half of pregnancy. The Northern Territory has a question on smoking consumption at the first antenatal visit and at 36-weeks gestation. Given the different questions asked in the five jurisdictions, comparisons between states and territories are difficult and there is no national agreement. In Australia, the two main sources of data collection for smoking during pregnancy are the National Drug Strategy Household Survey (NDSHS) and the National Perinatal Data Collection (NPDC). Both have certain limitations when it comes to collecting data on smoking during pregnancy. The NDSHS (2007) asks about (1) self-reported smoking status in last 12 months when subjects were