More than one in five mums in South Tyneside smoke during pregnancy, new figures released today show.
Figures released by the Health and Social Care Information Centre (HSCIC) show that, for 2015/16, out of 1,618 births there were 352 pregnant mums who were smokers at the time of a child's delivery.
That figure equates to 21.8% - more than double the national average of 10.6%.
Nationally, South Tyneside was the third worst area in England for pregnant smokers, with only Blackpool (26%) and North East Lincolnshire (23.5%) recording higher rates.
South Tyneside was also far higher than the north east average of 16%.
However, the 2015/16 figure is a decrease on the previous 12-month period, when 25.9% of pregnant women smoked.
A South Tyneside Council spokesperson said: "Our smoking at time of delivery rate is 21.8% for 2015/16 which is a statistically significant drop of four per cent.
"This improvement is very encouraging however we are aware that there is still much work to be done in supporting women to give up smoking.
"We are working closely with partners including the South Tyneside NHS Foundation Trust to ensure that pregnant women and their families are offered support to quit at every available opportunity throughout pregnancy.
"Part of this work involves reviewing the current pathway to make sure it is working to maximum effect and that there are no barriers that might stop women from accessing their local stop smoking services.
"Any pregnant woman looking to quit smoking should ask their midwife to be referred into Change4Life South Tyneside which offers advice and support on stopping smoking, healthier eating, cutting back on alcohol and where to have an NHS Health Check."
Elsewhere in the north east, Newcastle and Gateshead and North Tyneside had 13.2% rates, while Sunderland had 18%.
Ailsa Rutter, Director of Fresh Smoke Free North East, said: "Despite the figures showing that the North East still has the highest SATOD rates in England, we as a region have been taking a lot of positive steps to address this.
"Since the launch of the babyClear initiative in 2012, we’ve trained up hundreds of front-line maternity staff to talk about the dangers of smoking in pregnancy with expectant mothers, and automatically refer smokers into free, local support to help them quit.
"We now have around 1,500 fewer North East women who smoke in pregnancy, a drop of a quarter.
"It is clear that there is still some way to go to, but we have already seen some of the biggest drops in SATOD rates over last three years, thanks in no small part to the excellent work by North East midwifery staff and stop smoking services.
"We plan to continue to work with mothers-to- be to reduce maternal smoking rates further still."