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Smoking

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Smoking prevalence is the number of people who smoke tobacco in an area at a point in time. It is estimated from asking “Do you smoke cigarettes nowadays?” in three different annual household surveys.

Smoking in Pregnancy

14.6% of women smoke during pregnancy in Midlothian which is slightly higher than the Scottish average of 14.4%45. Midlothian used to have a higher rate than Scotland but this gap has now reduced. Note that there is evidence of under-reporting by women of their smoking behaviour at the booking appointment but this issue is being addressed, and has improved in recent years. This may have had an effect on prevalence levels and therefore trend data.

Following the Scotland trend, the percentage of women smoking during pregnancy in Midlothian increases as the level of deprivation increases with the highest percentage in the most deprived category (30%). Those living in the most deprived areas are approximately 6 times more likely to smoke during pregnancy than those in the least deprived areas.

Additionally, significantly fewer pregnant women made a quit attempt in Lothian (4 week quit rate: 18.1%,12 week quit rate: 11.0%) with the help of NHS smoking cessation services compared with the Scottish average (4 week quit rate: 31.7%, 12 week quit rate: 19.9%).

Deaths and illness related to smoking

There were around 3,400 smoking attributable hospital admissions per 100,000 of the population in Midlothian for the combined 3-year period 2012-201446. This was higher than the Scottish average (3,150 per 100,000 population). Contrasting with the Scottish average, this rate has been increasing since the 2008-2010 period, and has remained above the Scottish average since 2010-2012.

Two of the main health implications of smoking are COPD (see also COPD section) and lung cancer (see also Cancer section). Over the last decade the COPD incidence rate per 100,000 in Midlothian has improved such that the Midlothian rate (189) in the combined two year period of 2014/15 – 2016/17 is only slightly above the Scotland rate (180). The number of deaths from COPD in 2014-2016 per 100,000 is not significantly different from the Scottish average (77 vs. 93, respectively) but it is important to note that Midlothian rates have been increasing over time since 2011-2013 whereas Scotland has been falling.

Lung cancer remains the most common cancer overall in Scotland for both sexes combined, with 5,045 cases diagnosed in 2016. This accounted for 16.1% of all cancers in Scotland48 However, in both Scotland and Midlothian, rates of lung cancer registrations per 100,000 of the population have been decreasing since the period 2012-2014 Lung cancer deaths for 2014-2016 were also not significantly different from the Scottish average, with a decrease for Midlothian since 2012-2014.