How Does Smoking During Pregnancy Affect Your Baby?

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Gift your baby a healthy life by not smoking during pregnancy. Quitting smoking at any time before or during pregnancy is one of the best things you can do for your baby’s health. Not just that, you could lower risks to your health too.

If you have a habit of smoking, then it is not easy to stop it but it is not impossible either. In this post, MomJunction tells you how smoking can be harmful to your pregnancy and helps you quit the habit. Though it could be challenging, with a little effort and support, you can definitely stay smoke-free.

How Can Smoking Affect Your Pregnancy?

It is universally known that smoking is injurious to your overall health. Here, we will look at the pregnancy complications you are most likely to experience (1)):

  1. Preterm labor: The risk of preterm labor is higher for smokers than non-smokers. Although there are no detailed studies, it is believed that toxins in cigarette smoke could lead to high blood pressure and placental complications causing early delivery (2).
  1. Ectopic pregnancy: The breakdown product of nicotine, called cotinine, could lead to ectopic pregnancy, where the egg implants outside the womb (3).
  1. Placental problems: They include an early detachment of the placenta from the uterine wall (placental abruption) and blockage of cervical opening (placenta previa) (4). These conditions will lead to pregnancy loss.
  1. Premature rupture of the membranes: The amniotic sac ruptures prematurely, causing labor induction earlier than the actual due date (5).
  1. Umbilical cord implications: Smoking impairs placental development, reducing the flow of blood to the baby. Therefore, the umbilical cord cannot transfer sufficient oxygen and nutrients to the fetus, affecting its growth and development (6). It leads to bleeding during delivery and risks the life of the mother and the baby.
  1. Miscarriage: Women who smoke during their first trimester are likely to have a higher risk of a miscarriage than those who do not smoke. The risk is higher because of the lower levels of chorionic gonadotropin in women who smoke (7).

Smoking not just harms you and your pregnancy but also has a profound effect on the baby as well. The next section tells you about the various ways smoking can harm your baby.

[ Read: Second-Hand Smoke During Pregnancy ]

How Can Smoking During Pregnancy Affect Your Baby?

Smoking exposes your fetus to harmful chemicals that could limit oxygen and nutrient supply to it. Chemicals, including nicotine, tar and carbon monoxide present in the tobacco smoke, pass through the placenta into the fetus. This could, therefore, affect the growth and damage the baby’s heart, brain, and lungs (5).

Smoking increases the risk of (7):

  • Premature birth, where the baby is born before 37 weeks of pregnancy.
  • Birth defects, including defects of the mouth such as cleft palate or cleft lip. These malformations could also affect the development and working of the body.
  • Low birth weight of less than five pounds and eight ounces (2,500 grams).
  • Decreased fetal breathing and fetal movements (8).

Smoking during pregnancy can also affect the baby after birth. It will impair the child’s health in the years to come. It is likely to increase the risk of:

  • Respiratory illnesses such as asthma and tuberculosis (9).
  • Childhood obesity. Nicotine could affect the brain functioning that deals with eating impulses and metabolism (10).
  • Behavioral manifestations including chronic tic disorders and attention deficit hyperactivity disorder (ADHD) (11).
  • Cognitive, behavioral and developmental deficits such as cognitive impairment, impaired attention, poor impulse control, and learning deficits.

By quitting smoking, you will be taking care of your health as well as your baby’s.

What Can You Do To Quit Smoking?

Totally quitting smoking is the best thing to do. However, you can begin by cutting down on the number of times. Here are some ways to quit the habit (12).

  • Create a list of reasons for quitting and the consequences of not quitting. You could look at the list whenever you want to smoke.
  • Choose a quit day. Throw away all the cigarettes, lighters, ashtrays and other tobacco substances on that day.
  • Stay away from smoking triggers. You will feel like smoking when you are lonely or stressed. Or you may have the habit of smoking after a meal, while reading or while going for a walk. Learn ways to manage them. Begin a new practice such as reading a book, drinking milk or eating a snack or gum. Try some needlework or use a stress ball.
  • Stay in the company of a strong support system. Having a partner or a friend, who can control your temptation to smoke, could make a difference. Also, remain in the company of friends who do not smoke.
  • Make use of aids to help you quit. Find a cessation program from your healthcare provider.
  • Get rid of all smoking cues. Stay away from matches, ashtrays and also wash all the surfaces that may have the smoke residue.

Some quick quitting tips:

  • Drink lots of water, or have tea instead of coffee or alcohol.
  • Manage stress by practicing meditation, exercising, deep breathing or listening to music.
  • Celebrate one day, one week or one month of staying smoke-free.
  • Keep your mouth busy by chewing a candy, gum or involving in a craft.
  • Avoid going to places such as bars, restaurants, smoking sections or clubs.

When you have decided to quit smoking, you might want to try e-cigarettes as a replacement. In the next section, we tell you if you should even try them.

[ Read: Stress During Pregnancy ]

Is It Safe To Use E-Cigarettes During Pregnancy?

E-cigarettes also contain nicotine. The battery operated cigarettes turn chemicals such as nicotine to vapors that are inhaled. There are no studies to show that they are less harmful than cigarettes, and cannot be regarded as cessation aids.

Moreover, if you breathe in or touch the liquid in the e-cigarettes, it could lead to nicotine poisoning, which, in turn, results in breathing problems, weakness, nausea, and vomiting (13) (14).

Can You Use Nicotine Replacement Therapy During Pregnancy?

The best way to quit smoking is to do it without any medication. If that does not help, you may go for nicotine replacement therapy (NRT) such as nicotine gums, 16-hour patches, lozenges, inhalers or mouth sprays. Although they contain nicotine, they are at minimal levels. But NRT can only be tried under the doctor’s supervision and along with cognitive-behavioral therapy and counseling (15).

How Do You Feel After You Quit Smoking?

Harmful gases such as carbon monoxide will clear from your body, and reduce the risk of pregnancy complications. Your baby is also less likely to experience breathing problems later in their life.

However, as your body stops getting its supply of nicotine, you may experience withdrawal symptoms such as:

  • Craving cigarettes
  • Feeling irritable
  • Losing appetite
  • Frequently coughing
  • Depression
  • Headaches
  • Difficulty in concentrating

The above symptoms are temporary and decrease over time. When you are unable to manage these symptoms, think about the reasons for quitting. Understand that these are the signs of your body recovering from quitting smoking (16).

Secondhand Smoking And Its Effects On Pregnancy

Secondhand smoking, also referred to as passive smoking or environmental tobacco smoking, is a cloud of smoke you inhale from an external source. Here, you breathe in the smoke when someone smokes around you and exhales it. The smoke emitted from the end of a cigar or cigarette produces more dangerous chemical substances than the smoke inhaled by the smoker. It puts both you and your baby at risk (17) (18).

You are at an increased risk of giving birth to a low birth weight baby, preterm baby, stillbirth, baby with birth defects and other pregnancy complications.

Unborn babies and children are at a higher risk of developing allergies, asthma, lung or ear infections and SIDS.

Thirdhand Smoking And Its Effects On Pregnancy

Thirdhand smoke is the residue left over the surfaces, such as clothing, furniture, flooring, vehicles, walls, and toys, that have encountered cigarette smoke (19). When you either touch or breathe the surfaces containing the residue, you are likely to take in the toxins from the smoke. They could then enter into the fetus through your bloodstream.

Thirdhand smoke will stick to the surfaces for months.

Is Postpartum Relapse Common?

Studies state that the habit relapses in 29 – 85% of women who quit smoking during pregnancy. Most women go back to smoking soon after delivery because of having a family member or a partner who smokes, the pressure of taking care of the baby and postpartum depression.

If your habit has relapsed, try to analyze the reasons for relapse, and get counseling for support. Do not give in to the temptations. Instead, think of the ways to beat the urge to smoke because smoking could affect your baby even at this stage.

If you restart smoking after pregnancy, nicotine passes into the breastmilk and could affect the baby’s sleep and wake patterns (20). If you cannot refrain from smoking, you should:

  • Avoid smoking at least half an hour before you nurse the baby.
  • Do not smoke inside the house or near the baby.
  • Limit the number of cigarettes.
  • Wash your hands and face before holding or breastfeeding your little one.

[ Read: Measures To Control Your Anger During Pregnancy ]

It takes more than one attempt to stop smoking. You will get drawn to the habit again and again but it is worth trying. If you have a strong will to stop it, you can stop it, albeit gradually. Every time you get tempted, think about the harm you could do to your baby by smoking. That will be a strong motivator for you to quit smoking when pregnant.

How did you stop smoking when pregnant? Share your experience with us in the comments section below.


1. How smoking tobacco can affect your sex life and reproductive system; American Cancer Society
2. Marlene Anderka et al.; Patterns of tobacco exposure before and during pregnancy; Acta Obstet Gynecol Scand (2018)
3. Andrew W. Horne et al.; The association between smoking and ectopic pregnancy: Why Nicotine is bad for your fallopian tube; PLoS One (2014)
4. Bleeding in pregnancy/ placenta previa/ placental abruption; Stanford Children’s Health
5. Jeffrey E. Harris; Cigarette smoke components and disease: cigarette smoke is more thana triad of tar, nicotine, and carbon monoxide; Smoking and Tobacco Control Monograph No. 7
6. Morrow RJ et al.; Maternal cigarette smoking: The effects on umbilical and uterine blood flow velocity; Am J Obstet Gynecol (1988)
7. Renee Bittoun and Giuseppe Femia; Smoking cessation in pregnancy; Obstet Med (2010)
8. Thaler I et al.; Effects of maternal cigarette smoking on fetal breathing and fetal movements; Am J Obstet Gynecol (1980)
9. Kristen Bole; Smoking during pregnancy linked to persistent asthma in childhood; University of California San Francisco
10. Study links smoking during pregnancy with increase in obesity later in baby’s life; University of Kentucky
11. Heidi A. Browne et al.; Prenatal maternal smoking and increased risk for tourette syndrome and chronic tic disorders; Journal of the American Academy of Child & Adolescent Psychiatry’s (JAACAP) (2016)
12. Quitting smoking during pregnancy; At The Forefront UChicago Medicine (2017)
13. Understanding the implications of vaping and e-cigarettes; Keck School of Medicine of USC
14. White paper; Electronic cigarettes in the indoor environment; American Industrial Hygiene Association
15. Osadchy, Kazmin, Koren; Nicotine replacement therapy during pregnancy: recommended or not recommended? Journal of Obstetrics and Gynaecology Canada (JOGC) (2009)
16. Steps to help you quit smoking, how other moms have quit; Washington State Department of Health
17. Health effects of secondhand smoke; Centers for Disease Control and Prevention
18. Stop smoking in pregnancy; NHS (2017)
19. Peyton Jacob, III et al.; Thirdhand smoke: new evidence, challenges, and future directions; Chem Res Toxicol. Author manuscript (2018)
20. Julie A. Mennella et al.; Breastfeeding and smoking: short-term effects on infant feeding and sleep; Pediatrics (2008)


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