Smoking and Pregnancy: Why, How, and When to Quit

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Countless health risks are associated with smoking. Fortunately, it is one of the few things you can change that reduces the risk of complications before, during, and after pregnancy.

Who smokes?

Fortunately, thanks to public education campaigns, pregnant women (and women of reproductive age) are smoking at lower rates than in previous years. Still, in 2016, 7.2% of pregnant women reported smoking during pregnancy.1 Approximately 46% of women who smoke before pregnancy quit prior to or during pregnancy.2

Why quit?

Cigarette smoke contains thousands of toxic chemicals that can cause injuries and diseases to both mother and baby.3 Smoking can make it difficult to get pregnant,4 and smoking during pregnancy can cause babies to be born with low birthweight. It can also lead to preterm birth,2,5 miscarriage, or stillbirth.3

The risks of smoking continue after birth, with increased rates of asthma, colic, and childhood obesity in babies born to mothers who smoked while pregnant.1,2 Smoking during pregnancy may also cause SIDS (sudden infant death syndrome)—the unexplained death of a baby younger than 1 year old.3

Of course, smoking also increases long-term health problems for women, including heart disease, lung cancer, stroke, mouth and gum diseases, eye problems, diabetes, and premature death.1,3,6 In fact, smokers usually die about 10 years younger than nonsmokers.3

Quitting smoking can decrease these health risks. Quitting also helps you to have cleaner teeth and fresher breath, improves your sense of taste, improves the appearance of your skin, improves your vision, and allows you to have more energy so you can be healthier and more active.3

It’s not just smoking yourself that causes problems. Exposure to secondhand and third-hand smoke also increases the chance that you or your baby will have health problems.2 Secondhand smoke is smoke from someone else’s cigarette, cigar, pipe, or other tobacco product. When you breathe this in, it can be as harmful as breathing in the smoke from your own cigarette. Secondhand smoke can cause all the same problems and birth defects for unborn babies. If you continue to smoke around your baby after it is born, your child is more likely to have asthma, bronchitis, ear infections, and pneumonia.3

 Third-hand smoke is the chemicals left behind after someone smokes. It sticks to clothes, furniture, carpet, and walls, and even your skin and hair. It contains hundreds of chemicals that are potentially harmful to you and your baby. Simply opening a window while you smoke will not protect other people from the smoke.3

How can you quit?

Counseling, psychotherapy, and medicines can all play a part in your attempt to quit smoking. Some people have reported success with meditation, hypnosis, and acupuncture, but these may not help everyone quit smoking.2

Medications are available to help people quit smoking, but these are not proven to be safe during pregnancy. Nicotine replacement products and other medications may not offer enough benefits during pregnancy to outweigh their risks.2,7 As with any medication you consider using during pregnancy, talk to your doctor or pharmacist to make sure it is safe for you and your baby.

You may need to learn new coping skills to help manage cravings to smoke. Participating in a physical activity, even a short walk outside, may help the craving go away. You can also take deep breaths, talk to a friend, or distract yourself with a hobby or activity.6

Avoid situations or places where you know you will want to smoke.6 You will probably want to be around more non-smoking friends and family once you quit so you aren’t tempted to smoke. It is also smart to remove anything from your home, car, or office that reminds you of smoking, such as ashtrays, matches, and lighters.3

Reward yourself for reaching milestones while you are trying to quit. Celebrate 1 day, 1 week, or 1 month of being free of smoking!3

Who can help you quit?

At every prenatal visit, your doctor should ask you about tobacco exposure.2 If not, tell your doctor about your smoking habits and your exposure to secondhand smoke. If he doesn’t know about it, he can’t help you quit!

The national quit line (1-800-QUIT NOW) is available for all people who want to stop smoking. The counselors who answer the calls can refer you to local services and resources that can help you quit.2 You can also visit smokefree.gov to learn more about quitting smoking and sign up for free motivational text messages to help you stay on track with your goals.3

Your friends and family can also help you quit. Tell them your plans for quitting and they can help you make changes to support your goals.3

What is safe?

The use of e-cigarettes and vaping have increased in recent years, but there is little information about the health risks of these devices in pregnant women. These agents are not approved as devices to help you quit smoking and should not be used to cut down on the number of cigarettes you smoke (read a The Pulse blog about the risks of vaping during pregnancy here).2,3,8

Now is the time to quit!

Smoking is not just a bad habit. Addiction to cigarettes changes your mind and body and makes your body think it needs nicotine (the drug in tobacco).2,3 The length of time you have been smoking and the number of cigarettes you smoke can impact your motivation to quit and your quitting success.2 Quitting is a difficult journey, but support is available that can make it easier.2,5

Pregnancy usually makes women want to take better care of themselves so their babies stay healthy. In this way, pregnancy is a big motivation for women to quit smoking. Quitting before the 15th week of pregnancy offers the best chance for having a healthy baby but quitting any time can decrease the risks associated with smoking.2 Remember: there is no safe level of tobacco exposure while you are pregnant. Take advantage of the support offered by your healthcare providers to help you quit.

References:

  1. American Association for Respiratory Care. Smoking cessation for pregnant women. http://www.aarc.org/nn18-smoking-cessation-for-pregnant-women/.
  2. American College of Obstetricians and Gynecologists. Smoking cessation during pregnancy. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Smoking-Cessation-During-Pregnancy?IsMobileSet=false.
  3. March of Dimes. Smoking during pregnancy. https://www.marchofdimes.org/pregnancy/smoking-during-pregnancy.aspx.
  4. Centers for Disease Control and Prevention. Smoking during pregnancy. https://www.cdc.gov/tobacco/basic_information/health_effects/pregnancy/index.htm.
  5. Lumley J, Chamberlain C, Dowswell T, et al. Interventions for promoting smoking cessation during pregnancy. Coch Database Syst Rev. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090746/pdf/emss-58567.pdf
  6. American College of Obstetricians and Gynecologists. Smoking cessation during pregnancy: A clinician’s guide to helping pregnant women quit smoking. https://www.acog.org/~/media/Departments/Tobacco%20Alcohol%20and%20Substance%20Abuse/SCDP.pdf.
  7. Cressman AM, Pupco A, Kim E, et al. Smoking cessation therapy during pregnancy. Can Fam Physician. 2012;58(5):525-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352787/.
  8. Smokefree Women. Myths: smoking and pregnancy. https://women.smokefree.gov/pregnancy-motherhood/quitting-while-pregnant/myths-about-smoking-pregnancy.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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