The introduction of national, comprehensive smoke-free legislation in Scotland is linked with significant falls in preterm delivery and small for dates (gestational age) infants according to a study led by Jill Pell from the University of Glasgow and published in this week's PLoS Medicine.
These findings add to the growing evidence of the wide-ranging health benefits of smoke-free legislation and support the adoption of such legislation in other countries, which have yet to implement smoking bans.
The authors say: "There is growing evidence of the potential for tobacco control legislation to have a positive impact on health."
Scotland was the first country in the United Kingdom to ban smoking in public places, which was implemented as part of the Smoking, Health and Social Care (Scotland) Bill on 26 March 2006. In their study, the authors collected information on preterm delivery and small for dates in all babies born between January 1996 and December 2009 and found that following implementation of the legislation there was a significant reduction—a fall from 25.4% pre-ban to 18.8% post-ban— in the number of mothers who smoked. Furthermore, there was a significant drop (over 10%) in overall preterm deliveries and in the number of infants born small (a drop of almost 5%), and very small (a drop of nearly 8%). Importantly, the authors found that these significant reductions occurred both in mothers who smoked and those who had never smoked, emphasizing the impact on health of second-hand smoke.
According to the authors, although survival from preterm deliveries has improved, these infants are at risk of developing long-term health problems and state "Any intervention that can reduce the risk of preterm delivery has the potential to produce important public health benefits."
The authors conclude: "The results of our study add to the growing evidence of the wide ranging health benefits of smoke-free legislation and lend support to the adoption of such legislation in countries where it does not currently exist."
Funding: This study was funded by a Chief Scientist Office small project grant CZG/2/531. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: SHJ was seconded to the Scottish Collaboration for Public Health Research & Policy (SCPHRP) during the preparation of this manuscript but was employed by Health Scotland who funded the work. All other authors have declared no competing interests.
Citation: Mackay DF, Nelson SM, Haw SJ, Pell JP (2012) Impact of Scotland's Smoke-Free Legislation on Pregnancy Complications: Retrospective Cohort Study. PLoS Med 9(3): e1001175. doi:10.1371/journal.pmed.1001175
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