Smoking during pregnancy: Risks and how to quit

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Smoking at any time during a pregnancy can harm a person and fetus.

Research from 2020 suggests that the biggest benefit can occur if a person stops smoking before 15 weeks of gestation.

If a person stops smoking before 15 weeks, it can reduce the risk of fetal growth restriction (FGR). FGR is a condition that can cause a baby to be smaller than average when born. The condition can result in the baby developing certain health issues, such as:

• enlarged liver
• hearing loss
• inflammation in the choroid, which is part of the eye
• blue or purple marks on the skin, known as blueberry muffin spots
• low set ears
• cleft palate
• Edwards syndrome, a serious genetic condition that can affect how a baby develops and grows
• scalp abnormality
• close-set eyes
• coloboma, which is an area of missing tissue in the eye
• micrognathia, a condition that causes an undersized lower jaw
• umbilical hernia, which is where part of the bowel pushes through a weak spot on the abdominal wall

The Centers for Disease Control and Prevention (CDC) state that people who smoke have more difficulty becoming pregnant. Additionally, they have a higher risk of never being able to conceive.

The CDC also notes that stopping smoking before becoming pregnant is safest. However, stopping smoking at any stage of pregnancy can still help prevent further problems from developing.

Smoking during pregnancy increases a person’s risk of vaginal bleeding, as well as:

• Preterm labor: Preterm labor is when a person goes into labor too early. This can cause a baby to be born prematurely. Premature babies can have a higher risk of health problems when they are born and as they get older.
• Ectopic pregnancy: Ectopic pregnancy occurs when a fertilized egg implants outside the uterus. This can cause serious, life threatening issues for a pregnant person. Ectopic pregnancies always end in pregnancy loss.
• Issues with the placenta: The placenta is a temporary organ that develops inside the uterus. It supplies the fetus with oxygen and nutrients. Issues with the placenta can result in preterm labor or pregnancy loss.

Smoking while pregnant can result in toxic chemicals passing from a person to the fetus. These chemicals can cause serious damage to the fetus and may result in pregnancy loss.

If a person smokes while pregnant, the baby has an increased risk of:

• premature birth
• lung or brain damage
• congenital anomalies, such as a cleft lip
• having a low birth weight
• sudden infant death syndrome (SIDS), which is the unexplained death of a baby before they are 1 year old

Secondhand smoke is smoke that another person has exhaled. Breathing in secondhand smoke can be dangerous for a pregnant person and fetus.

Exposure to secondhand smoke during pregnancy can cause the baby to have a low birth weight or congenital disabilities. A pregnant person should avoid being around people who smoke.

Additionally, babies exposed to secondhand smoke after they are born are at risk of health issues, such as:

• asthma
• bronchitis
• ear infection
• pneumonia
• SIDS

It is safest to stop smoking altogether before and after pregnancy. However, if a person does smoke, they should avoid doing so around a baby.

There is limited information regarding e-cigarette smoking and pregnancy. This is because e-cigarettes are relatively new products. Researchers need to conduct more studies to determine their long-term effects on pregnancies.

However, e-cigarettes contain many of the same chemicals as cigarettes. The liquid inside an e-cigarette typically contains nicotine and chemicals that can cause lung and breathing conditions. These chemicals include:

• acrolein
• diacetyl
• diethylene glycol
• cadmium
• benzene

E-cigarettes can also contain carcinogens, which are chemicals that cause cancer.

A person should avoid smoking e-cigarettes while pregnant. They should also stay away from people smoking them.

Nicotine replacement therapy (NRT) is when a person uses nicotine-containing products to replace cigarettes. Information from the American Cancer Society notes that using NRT can almost double a person’s chances of quitting smoking. NRT products include:

• gum
• sprays
• inhalers
• lozenges
• patches

NRT is a safe alternative to cigarettes as it does not contain the toxic chemicals found in cigarettes. However, a person should not use NRT during pregnancy.

Other methods a person can use to quit smoking include:

• choosing a day to quit and sticking with it
• getting support from other people
• exercising
• getting out of the house
• chewing gum or hard candy
• keeping the hands busy with items such as a pen or straw
• staying hydrated
• relaxing
• going to the movies or for a meal
• disposing of cigarettes and other smoking equipment
• avoiding caffeine
• visiting places where smoking is not allowed
• getting lots of rest
• eating a balanced, nutritious diet
• avoiding smoking triggers

Learn about nicotine withdrawal symptoms and how to manage them here.

Many people and places can provide support for a person who wants to quit smoking. Options include:

• friends and family
• text message support, such as SmokefreeTXT
• smartphone apps, such as quitSTART and QuitGuide
• telephone quitlines, such as the National Cancer Institute Quitline
• LiveHelp, an online chat support service
• websites such as Smokefree, American Lung Association, and CDC

Learn what happens after quitting smoking here.

Smoking while pregnant can cause a person to develop many different health issues. A person should consult a doctor if they experience new or unusual symptoms during pregnancy.

A person should seek immediate medical attention if they have any symptoms of an ectopic pregnancy, such as:

• sudden, severe pain in the abdomen or pelvis
• chest or shoulder pain
• dizziness, weakness, or fainting
• vaginal bleeding or spotting

Symptoms of an issue with the placenta that require urgent medical attention include:

• vaginal bleeding
• pain
• contractions
• discomfort or tenderness
• sudden abdominal or back pain

Smoking while pregnant can cause serious harm to a person and their baby. The CDC lists the following possible outcomes for people who smoke during pregnancy and their babies:

• Around 1 in 5 babies will have a low birth weight.
• Babies are three times more likely to have SIDS.
• There is double the risk of a person having abnormal bleeding during pregnancy.

If a person quits smoking while pregnant, they may experience the following benefits:

• increased oxygen to the fetus
• increased fetus growth
• reduced risk of preterm labor
• improved breathing
• more energy
• lower risk of conditions such as cancer, heart disease, and stroke

Smoking while pregnant can cause serious, life threatening harm to a person and their baby. Secondhand smoke and e-cigarettes can also be harmful.

Although quitting smoking at any time during pregnancy is beneficial, it may cause the least harm if a person quits in the first 15 weeks of gestation.

There are many methods a person can use to help them stop smoking. Additionally, many forms of support are available for a person who wants to quit. If a person is having difficulty giving up smoking, they can talk with a doctor.

People should seek immediate medical attention if they notice any serious symptoms during pregnancy.