Almost six out of 10 teenage mothers are continuing to smoke during pregnancy – despite a significant decline in the number of younger people smoking over the past year.
The figures have dismayed experts and could mean the government will miss key targets for improving the nation's health.
The issue of young mothers who smoke while pregnant was in the spotlight last week when celebrity Stacey Solomon, who made her name as an X-Factor finalist, admitted she was still smoking two months before she was due to give birth. Amid the ensuing furore, Solomon was publicly stripped of her celebrity mum of the year title by a gambling website.
Department of Health data, published on the first anniversary of health secretary Andrew Lansley's tobacco control plan, shows the percentage of people in England who smoke has fallen from 21% to 20% over the past year. There was a 5% decline in the number of younger smokers, with younger women in particular turning away from cigarettes.
Over the past 10 years the proportion of teenage girls who smoke has fallen to an all-time low, from 31% to 17%. But one in four women smokes during part of her pregnancy as the long-term decline in smoking in pregnancy has all but come to a halt. And a particular concern is smoking among pregnant teenagers. A meeting of experts at the Royal College of Paediatrics and Child Health heard that nearly six out of 10 pregnant teenagers smoke. Only around a third of them managed to quit, compared with around two thirds of older mothers.
The meeting heard that depressed women are up to four times more likely to smoke during pregnancy than non-depressed women, and that between 25% to 50% of pregnant smokers have mental health problems.
The government wants to reduce the percentage of women who smoke at the time of delivery to 11% by 2015. But the figure dropped by just 0.1% last year to 13.4%, largely because teenage mothers decline to stop, suggesting the target will not be achieved.
Socioeconomic factors are thought to play a key role in determining whether teenagers smoke during pregnancy and whether they will quit. According to Action on Smoking and Health, Ash, women from routine and manual groups are almost three times as likely to smoke as women classed "managerial and professional".
Sociologists suggest that for teenagers smoking is often the norm. In contrast, women who have babies later are much more likely to come from communities where smoking is less common.
"The number of teenagers who smoke is falling fast, but you have to ask yourself, are the most disadvantaged young people getting left behind?" said Martin Dockrell, director of policy and research at Ash.
"When you look at the figures about smoking among teenagers, you are looking at young women with a double disadvantage. First, these are young women approaching the peak age for smoking. By the time women reach 25 they start to quit in large numbers.
"Second, better-off women tend to have their children later, so these are women, on the whole, not just younger but also less well off."
The analysis suggests health officials need to find new ways of encouraging teenage mothers to stop smoking. It complements research by Professor Hilary Graham of York University's department of health sciences that has found education, the age of becoming a mother and lone parenthood are all linked to a greater incidence of smoking during pregnancy.
Graham has argued that government policy on smoking has led to public vilification of disadvantaged groups – including teenage mothers who are seen as "Vicky Pollard" style characters.
As a result, the current government strategy of "promoting lifestyles more commonly found in middle-class communities is unlikely to promote social cohesiveness", Graham argues.
"Research shows that the health behaviours of those around us – be that smoking or quitting – make a bigger difference to our own behaviours than we realise," Dockrell said.
"I think that's part of the reason why younger women are not just more likely to smoke but also much less likely to quit."
