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Harmful Effects of Smoking During Pregnancy and How to Stop

In the U.S., there are an estimated 42 million people (nearly 18% of the total population) who currently smoke.1 Tobacco use is the leading cause of preventable disease, disability, and death in the U.S. In fact, smoking accounts for nearly 1 in every 5 deaths each year.2

Effects of Smoking on a Baby

Cigarette smoke contains thousands of harmful chemicals. When a woman smokes during pregnancy, these toxic chemicals enter her bloodstream and increase the risk of fetal injury. The nicotine and carbon monoxide in cigarettes are especially harmful because they can damage a baby’s developing brain and make it difficult for them to get enough oxygen. Nicotine narrows the blood vessels in the umbilical cord, which can result in inadequate levels of oxygen exchange for the developing baby.

Smoking increases the risks of prenatal issues, complicated births, and a number of peripartum and newborn health issues. Risks include:3,4,5

  • Miscarriage.
  • Low birth weight.
  • Premature birth.
  • Stillbirth.
  • Ectopic pregnancy.
  • Spontaneous abortion.
  • Placenta previa.
  • Placental abruption.
  • Sudden infant death syndrome (SIDS).

When babies are born too early, they are deprived of the safe environment and regular developmental duration that they would have otherwise experienced in the womb. The earlier a baby is born, the greater the chances are that they will experience health issues. In some cases, premature birth can result in infant death.

Premature babies may experience:8,9

  • Problems with feeding.
  • Respiratory distress.
  • Cerebral palsy.
  • Delays in development.
  • Problems with hearing or eyesight.

If a baby is born prematurely, they will often need to be hospitalized for days or even months so that doctors and nurses can safely monitor their progress.

The harmful effects of prenatal exposure to smoking are not limited to childhood. Negative effects can last throughout a child’s lifetime. Studies have found that children who are exposed to tobacco in utero have significantly higher odds of having a learning disability later on.10 Children born to mothers who smoked a pack or more a day during pregnancy are also significantly more likely to be smokers themselves when they grow up.11


Electronic cigarettes (also referred to as e-cigarettes) are hand-held battery-operated devices that people use to smoke a liquid that is made of nicotine, flavoring, and other chemicals. The battery in the device heats the liquid nicotine to create an aerosol that the smoker then inhales.12


The use of e-cigarettes has become increasingly popular. According to Forbes, e-cigarette sales generate over $1 billion every year.

People often think that e-cigarettes are safer than tobacco cigarettes, which may lead them to smoke more freely during pregnancy.13 For pregnant women, the chemicals in e-cigarettes can cause adverse effects for their baby.

E-cigarettes contain nicotine—a potent teratogen or, in other words, an agent that can be profoundly harmful to prenatal development.13 Nicotine crosses the placental barrier and studies have found that it can cause a significant amount of damage to the development and well-being of a fetus.

In animal studies, nicotine has been found to cause:14,15

  • Respiratory problems, including impaired lung function and decreased lung size. (This may affect both first- and second-generation offspring.)
  • Reduced fertility for female offspring.

Some people turn to e-cigarettes to help them stop smoking tobacco. However, there is no evidence that e-cigarettes are a safe alternative to cigarettes. In fact, to date, no e-cigarette is approved by the FDA for smoking cessation purposes.16 This is due in part to the fact that e-cigarettes are currently unregulated and contain nicotine at varying levels.

If you are pregnant and currently smoking e-cigarettes, talk to your doctor about the risks and benefits of exposing your baby to nicotine during pregnancy.

Dangers of Secondhand Smoke

Secondhand smoke (SHS) refers to the potentially inhaled smoke resulting from another person’s smoking. Just like immediately inhaled cigarette smoke, SHS is a human carcinogen—which means it contains chemicals that cause cancer.17 SHS can cause a number of negative health problems in children and adults.

Exposure to SHS during pregnancy is associated with an increased risk of:18,19

  • Low birth weight.
  • Preterm delivery.
  • SIDS.

Babies who are exposed to SHS after they are born are more likely to die from SIDS compared to babies who are not exposed to cigarette smoke.19

Babies exposed to SHS also have weaker lungs than other babies, which can increase their risk of encountering other chronic health problems such as asthma, ear infections, bronchitis, and pneumonia.19

Credit: American Medical Association

Quitting Smoking While Pregnant

Quitting smoking during pregnancy is one of the most important steps a woman can take to improve her health. It will help you feel better and provide a healthier environment for your baby.

Keep in mind that many people try to quit multiple times before they are successful. It is difficult to quit smoking, and you are not a failure if you “slip.” The important thing is to keep trying.

If you are in the process of quitting smoking, below are some useful strategies to help you handle cravings and avoid triggers:28

  • Engage in physical activity, such as walking, jogging, running, swimming, or dancing.
  • Practice deep breathing at least once a day. Take long, slow breaths to center yourself.
  • Talk to friends and loved ones.
  • Write down your thoughts and feelings in a journal or blog.
  • Remind yourself that you are not a smoker—identity is powerful, and identifying yourself as a nonsmoker can help you quit and stay tobacco-free.
  • Spend time with people who don’t smoke.
  • Ask others not to do it in front of you.
  • Establish a “smoke-free” zone in the car or house.
  • Identify triggers, such as people or stressful situations that cause you to want to smoke. Avoiding these triggers can help you stay drug-free.
  • Redirect your focus and attention when a trigger makes you want to smoke: immediately go for a walk, listen to music, call a friend, or brush your teeth.
  • Reduce stress in your life, such as work stress or personal stress.
  • Eat a healthy diet, drink plenty of water, and get at least 8 hours of sleep each night.

When you stop smoking, your baby will be able to get more oxygen. Quitting will also reduce the risk that your baby is born prematurely.

Some women may feel guilty or ashamed about their smoking, but every mother wants the best for her child. Try not to let fear stand in the way of getting help. There are numerous resources available for individuals looking to quit. You can call 1-800-44U-QUIT, a national quitline for pregnant women seeking to end their tobacco use.

If you are abusing any other substances like alcohol that may also cause potential harm during your pregnancy, please reach out to American Addiction Centers (AAC) today free at . You and your baby deserve to be healthy.

Are Nicotine Replacement Therapies Safe During Pregnancy?

While nicotine replacement therapy (NRT) is shown to be highly effective in non-pregnant individuals, there is not evidence to determine whether or not NRT is safe and effective for use among pregnant smokers.29 More data is needed to determine whether or not NRT is safe to use during pregnancy given that there is conflicting and inconclusive evidence in the research community regarding its use.30

Gynecologists may recommend nicotine replacement therapy only after a woman has tried behavioral therapy interventions and they have failed.31 A doctor should first discuss the risks and benefits of nicotine replacement therapy before prescribing it to a pregnant patient.

Woman putting on a nicotine patch

Below are a few facts about these medications:30,31

  • Varenicline acts on the brain’s nicotine receptors.
  • Bupropion is an antidepressant.
  • Both of these medications are transferred through breast milk.
  • The U.S. Food and Drug Administration recently added warnings on these products because they increase the risk of psychiatric symptoms and suicide.

There is currently not enough evidence to conclude whether any of these medications are safe to use during pregnancy.

Mothers can breastfeed while being on nicotine replacement therapy as long as the dose is less than the number of cigarettes usually smoked. Women should first consult their doctor before breastfeeding and using nicotine replacement therapy, since a baby can be exposed to nicotine through a mother’s breast milk. Additionally, the FDA discourages lactating women from using other smoking cessation pharmacotherapies such as bupropion and varenicline.32

Handling Nicotine Withdrawal

An addiction to tobacco can have both physiologic and psychological components, potentially compounding the difficulty of quitting.

In order to quit smoking, a physician may recommend any of the following cessation techniques:33

The acute nicotine withdrawal syndrome has a number of unpleasant associated symptoms. These are normal and will last for a few days to a few weeks.

Symptoms of withdrawal may include:10

  • Negative moods.
  • Urges to smoke.
  • Difficulty concentrating.

Women who smoke during pregnancy are encouraged to stop smoking and seek help. Although physicians recommend quitting smoking before 15 weeks of gestation for the greatest benefits to the baby and the mother, quitting at any point is beneficial.34

Additional Resources to Help You Quit Smoking

If you are addicted to smoking and looking for ways to quit, below are a few resources designed to help you.

Additionally, extra cessation therapy is offered to pregnant women under the Affordable Care Act, or ObamaCare.35 This includes free counseling and medication—as approved by a doctor.36

Quitting smoking can be challenging, but there are more resources than ever available to help you quit.

If you’re struggling with substance addiction, don’t wait to get help. American Addiction Centers (AAC) is a leading treatment provider and has trusted rehab programs across the country. When you call one of our caring representatives free at , they can help you find the care you need to quit today and become as healthy as possible for yourself and your child.

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