Smoking and Pregnancy

  • By:  Melissa Waddell, WHNP

Smoking and pregnancy don’t mix. Find out how smoking hurts your baby and you!

Cigarettes and cigars are made from tobacco leaves. Tobacco contains a drug called nicotine. Nicotine is what makes you become addicted to smoking. Addiction is a brain condition that makes you smoke, even if you don’t want to. Addiction affects your self-control and your ability to stop smoking.

Smoke from tobacco contains more than 7,000 chemicals. At least 250 of these are harmful to smokers and nonsmokers. At least 69 of them can cause cancer. Breathing even a little tobacco smoke can be harmful.

Smoking during pregnancy can lead to serious harm. Women who smoke during pregnancy are more likely than those who do not smoke to have problems such as:

  • Preterm labor – This is labor that starts before 37 weeks of pregnancy (3 or more weeks before your due date). Pregnancy normally lasts about 40 weeks, counting from the first day of your last period. Going into labor before 37 weeks of pregnancy can be dangerous because babies who are born preterm (also called “premature”) can have serious health problems.
  • Problems with the placenta – These can include “placenta previa” and “placental abruption.” Placenta previa happens when the placenta covers the opening of the cervix. Placental abruption happens when the placenta separates from the mother’s uterus before the baby is born. Both of these problems can cause bleeding from the vagina and be dangerous for the mother and baby.
  • Miscarriage – A miscarriage is when a pregnancy ends before 20 weeks of pregnancy.
  • Stillbirth – A stillbirth is when a baby dies before it is born, in the second half of pregnancy (after 20 weeks).

There are also risks to babies whose mothers smoke during pregnancy. These babies are more likely than babies whose mothers do not smoke to:

  • Be premature or be born too small – Babies who are premature or small are more likely to have problems with feeding, sleeping, breathing, seeing, and hearing.
  • Die suddenly for no known reason before the age of 1 year (this is called “sudden infant death syndrome” or “SIDS”). In a United States birth cohort study, even smoking just one cigarette daily throughout pregnancy doubled the risk for SIDS. Moreover, women who reduced or quit smoking during pregnancy cut the SIDS risk by 12 and 20 percent, respectively.

Electronic cigarettes have become very popular in the past couple of years. Many believe that they are harmless, but it is best to also avoid using e-cigarettes during pregnancy. Using e-cigarettes is also called “vaping.” E-cigarettes contain nicotine, which is the harmful substance found in regular cigarettes.

There are treatments that are available to help with trying to quit smoking. Your doctor or nurse can give you advice on the best way to quit. He or she can also put you in touch with counselors or other people you can call for support. The letters in the word “START” can help you remember the steps to take:

S = Set a quit date.

T = Tell family, friends, and the people around you that you plan to quit.

A = Anticipate or plan ahead for the tough times you’ll face while quitting.

R = Remove cigarettes and other tobacco products from your home, car, and work.

T = Talk to your doctor about getting help to quit.

The earlier you can quit smoking in your pregnancy, the better. But stopping at any point can still help. If you cannot quit, smoking fewer cigarettes can help, too.

It’s also very important not to start smoking again after your baby is born. Babies who are around smoke from cigarettes (called secondhand smoke) have a higher-than-normal risk of health problems, such as colds and ear infections. Quitting for good also lowers your chances of heart disease and cancer. And it sets a good example for your child not to smoke.

Medications To Help You Quit Smoking Has Tips for Pregnant Women Who Smoke


While cessation counseling is the first line treatment for all patients, some patients find that counseling alone is not enough. We offer medications to help pregnant patients who are unable to quit or at high risk of continued smoking. These women include those who are heavy smokers (>10 cigarettes per day), those smoking later in pregnancy, and those who have been unsuccessful in a previous attempt to stop. We believe the benefits of quitting with the use of medications outweigh the potential risks of both medications and the risks of continued smoking.

Ask your doctor which medications would be safest for you and your baby. Examples of some medications that can help you quit include:

  • Nicotine replacement therapy – This includes skin patches, lozenges, and gum that have nicotine. Prescription forms include nasal sprays and “puffers” (also called “inhalers”).
  • Bupropion (sample brand names: Zyban, Wellbutrin) – This prescription medicine reduces your desire to smoke. It is also available in a generic version, which is cheaper than the brand name ones. has a free text message program for pregnant women who are trying to quit. It also has a free app you can download to keep you on track. Call 1-800-QUIT-NOW for advice from a quit smoking counselor. Look for programs in your community or where you work that can help you stop smoking. These are called smoking cessation programs.

Ask your provider about programs in your area. Ask your employer to see what services are covered by health insurance. Tell your family, friends, and loved ones about your plan to quit smoking. They can help support you. Other things to do to help you quit:

  • Drink lots of water. Drink water or tea instead of coffee or alcohol.
  • Try to manage your stress. Stress can be a trigger for smoking. Try things to relieve stress, like meditation, deep breathing, exercising, or listening to your favorite music.
  • Reward yourself for your progress. Celebrate milestones, like 1 day, 1 week and 1 month of being smoke-free.

If you have trouble quitting, keep trying! You’re doing what’s best for you and your baby.

Melissa Waddell, WHNP. is a nurse practitioner at Atlantic Ob/Gyn. Call 757-463-1234 or visit

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