Smoking causes widespread damage to children's health and may increase the risk of foetal malformations according to a report from the British Medical Association.

The investigation into the impact of tobacco on reproductive and child health examines how parental smoking affects children from conception onwards. Researchers said exposure to passive smoking was risky during pregnancy and could have long-term and serious consequences for child health.

The BMA has called for fully paid leave for pregnant employees who cannot be protected from passive smoking during pregnancy and more ambitious government targets to reduce overall smoking rates.

In the report, researchers linked passive smoking with cot death, respiratory infection in children and the development of childhood asthma. There is also substantial evidence linking it to reduced foetal growth and premature birth.

The report includes new evidence that smoking may increase the risk of certain foetal malformations, such as cleft lip and palate.

Women who smoke during pregnancy are three times more likely to have a low birth weight baby - something that is closely linked to illness and death in infancy. Smoking during pregnancy also increases the risk of miscarriage, still-birth and death of the newborn. Smoking can compromise breastfeeding, with women who smoke producing less milk, of poorer quality, said researchers.

Exposure to second-hand smoke in childhood is associated with increased hospitalisation. It is estimated that each year more than 17,000 children under five years old are admitted to UK hospitals because of respiratory illness caused by exposure to cigarette smoke. 

- Smoking and Reproductive Life - the Impact of Smoking on Sexual, Reproductive and Child Health is available at www.bma.org.uk/ap.nsf/Content/SmokingReproductiveLife