{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:36:16Z","timestamp":1783658176863,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T00:00:00Z","timestamp":1519948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["RP\u2010PG\u20100109\u201010020"],"award-info":[{"award-number":["RP\u2010PG\u20100109\u201010020"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Little is known about the long\u2010term economic consequences of smoking during pregnancy. We estimated the association between smoking in pregnancy and the costs of delivering health\u2010care to infants and children in England, and investigated which aspects of care are the key drivers of these costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used Hospital Episode Statistics (HES) linked with Clinical Practice Research Datalink (CPRD) data in England from January 2003 to January 2015 in children with longitudinal data for at least 1, 5 and 10\u00a0years after birth. Poisson regression provided rate ratios (RR) and 95% confidence intervals (CIs) comparing health\u2010care episode rates between those exposed and not exposed to smoking during pregnancy. Linear regression was used to compare estimated costs between groups (\u00a3 sterling, 2015 prices) and generalized linear multivariable (GLM) models adjusted for potentially moderating factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 93\u2009152 singleton pregnancies with the required data were identified. Maternal smoking in pregnancy was associated with higher primary care, prescription and hospital in\u2010patient episode rates, but lower out\u2010patient visit and diagnostic test rates. Adjusting for year of birth, socio\u2010economic deprivation, parity, sex of child and delivery method showed that maternal smoking in pregnancy was associated with increased child health\u2010care costs at 1\u00a0year [average cost difference for children of smokers, \u03b2\u00a0=\u00a0\u00a391.18, 95% confidence interval (CI)\u00a0=\u00a0\u00a347.52\u2013134.83 and 5\u00a0years of age (\u03b2\u00a0=\u00a0\u00a3221.80, 95% CI\u00a0=\u00a0\u00a317.78\u2013425.83], but not at 10\u00a0years of age (\u03b2\u00a0=\u00a0\u00a3365.94, 95% CI\u00a0=\u00a0\u2013\u00a3192.72 to \u00a3924.60).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In England, maternal smoking in pregnancy is associated with increased child health\u2010care costs over the first 5\u00a0years of life; these costs are driven primarily by greater hospital in\u2010patient care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14183","type":"journal-article","created":{"date-parts":[[2018,2,3]],"date-time":"2018-02-03T11:26:39Z","timestamp":1517657199000},"page":"1305-1316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Estimating the health\u2010care costs of children born to pregnant smokers in England: cohort study using primary and secondary health\u2010care data"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2184-1234","authenticated-orcid":false,"given":"Luis R.","family":"Vaz","sequence":"first","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, Division of Primary Care University of Nottingham Medical School, Queen's Medical Centre  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4824-9724","authenticated-orcid":false,"given":"Matthew J.","family":"Jones","sequence":"additional","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, Division of Primary Care University of Nottingham Medical School, Queen's Medical Centre  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Szatkowski","sequence":"additional","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health University of Nottingham  Nottingham City Hospital Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila J.","family":"Tata","sequence":"additional","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health University of Nottingham  Nottingham City Hospital Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Petrou","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, Warwick Medical School University of Warwick  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Coleman","sequence":"additional","affiliation":[{"name":"UK Centre for Tobacco and Alcohol Studies, Division of Primary Care University of Nottingham Medical School, Queen's Medical Centre  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-213"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14622200410001669187"},{"key":"e_1_2_8_4_1","article-title":"Pharmacological interventions for promoting smoking cessation during pregnancy","volume":"9","author":"Coleman T.","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_5_1","unstructured":"JonesM.The development of the economic impacts of Smoking In Pregnancy (ESIP) model for measuring the impacts of smoking and smoking cessation during pregnancy. 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