Smoking during pregnancy can cause babies to be born too small or too early (preterm birth), certain birth defects, and stillbirth. Quitting smoking can be hard, but it is one of the best ways a woman can protect herself and her developing baby. For free help, call 1-800-QUIT-NOW (1-800-784-8669).

Many people know that smoking causes cancer, heart disease, and stroke. But women who smoke during pregnancy put themselves and their developing babies at risk for other health problems. Even being around tobacco smoke puts a woman and her developing baby at risk for health problems.

Smoking during Pregnancy Affects Your Developing Baby’s Health

Smoking during pregnancy can cause babies to be born too small or too early. Women who smoke during pregnancy are more likely to have a baby with a birth defect of the mouth and lip called an orofacial cleft.

Babies who breathe in other people’s tobacco smoke are more likely to have ear infections and lung infections, like bronchitis and pneumonia; if they have asthma, breathing in other people’s tobacco smoke can trigger asthma attacks. These babies are also more likely to die from Sudden Infant Death Syndrome (SIDS), a sudden and unexpected infant death that has no immediately obvious cause after investigation.

It Is Never “Too Late” to Quit Smoking During Pregnancy!

Quitting smoking before getting pregnant is best. But for women who are already pregnant, quitting as early as possible can still help protect against some health problems for their developing babies, such as being born too small or too early. It is never too late to quit smoking.

It is important to quit smoking for good. A women might think it is safe to start smoking again after her baby is born. But babies of mothers who smoke may breathe in the secondhand tobacco smoke that can harm their health. Although quitting for good can be hard, the benefits are worth it—a healthy baby and many more years of good health to enjoy with him or her.

If you or someone you know wants to quit smoking, talk to your healthcare provider about strategies. For support in quitting, including free quit coaching, a free quit plan, free educational materials, and referrals to local resources, please call 1-800-QUIT-NOW (1-800-784-8669); TTY 1-800-332-8615.

Know the Facts

In 2010, data from 27 PRAMS sites, representing 52% of live births, showed that among women with recent live births:

• About 23% reported smoking in the 3 months prior to pregnancy.
  • More than half of these smokers (54%) reported that they quit smoking by the last 3 months of pregnancy.
• Almost 11% reported smoking during the last 3 months of pregnancy.
• Almost 16% reported smoking after delivery.

If you’re pregnant or planning to have a baby, you probably know that smoking cigarettes is a health threat for you and your baby. Many women make it a goal to quit during this time in their lives.

It’s most helpful for you and your baby to quit smoking before you get pregnant. But if you’re already pregnant, quitting can still help protect you and your baby from health problems.

Health problems caused by smoking cigarettes can be serious. For example, your baby can be born too early or have a birth defect. And even if you smoked cigarettes and had a healthy pregnancy in the past, that does not mean it’s safe to smoke during your next pregnancy. When you smoke cigarettes during pregnancy, you put your health and your baby’s health at risk.

Some women might think it is safe to start smoking again after their baby is born. But your baby is not out of harm’s way.

• Babies who breathe secondhand smoke are more likely to die from sudden infant death syndrome (SIDS).
• Babies who are around cigarette smoke have weaker lungs than babies who are not around cigarette smoke.
• Babies who are around cigarette smoke are more likely to have ear infections and breathing problems.

Though quitting smoking can be hard, the benefits are worth it!

• You’ll increase your chances of having a healthy baby.
• You’ll breathe better.
• You’ll be surprised how much easier it is to be active.

Smoking before, during, and after pregnancy is harmful to both you and your baby. It’s never too late to gift yourself and your new baby a healthier future and quit.

Smoking can make it harder for you to get pregnant. And, if you get pregnant, continuing to smoke while you’re pregnant can cause serious harm to your baby’s health. Even if you smoked during a past pregnancy and had a healthy baby, every pregnancy is different. Quitting smoking at any time during pregnancy—especially early on―can give your baby a healthier start in life.

After your baby is born, exposing your baby to secondhand smoke also causes harm to your child’s health and development. Understand the risks of continuing to smoke before and after your baby is born. Quitting will give you and your baby a brighter and healthier future.

Smoking While Pregnant

Smoking can cause complications during your pregnancy, such as:

• Miscarriage: an unexpected loss of the baby.
• Ectopic pregnancy: when the fertilized egg implants outside the uterus (where the baby usually develops). The result is usually a miscarriage.
• Placental abruption: when the placenta (this provides oxygen and nutrients to the baby) separates too early from the uterus. This can cause bleeding in the mother. It can also lower or stop the baby’s supply of oxygen and food.
• Placenta previa: when the placenta covers the cervix (the lower end and opening of the uterus). This can cause severe bleeding during pregnancy and delivery.
• Preeclampsia: when the mother experiences high blood pressure and swollen feet, legs, and hands. This can have severe complications for both the mother and baby, like placental abruption and having a premature baby.
• Preterm birth: when the baby is born too early. Babies who survive early delivery can have problems breathing, digestion issues, and bleeding in their brains. As the child gets older, he or she may experience developmental delays (when a baby or child is behind in language, thinking, or movement skills) and not do as well in school.

Have a Healthy Baby

Quitting before you give birth will give your baby these benefits:

• Less risk of being born too early.
• Less risk of being born with birth defects like cleft lip or cleft palate.
• Higher chance of having a healthy birth weight (more than 5.5 pounds) and growing on track.
• More likely to come home from the hospital with you. Babies who are too small or who need care for health problems may need to stay in the hospital until they are healthy enough to go home.
• Increased chance lungs will develop well.
• More likely to have normal brain development before birth and through early childhood.
• Less likely to die from sudden infant death syndrome (SIDS).

Staying Smokefree After Baby

Once you bring your baby home, it’s just as important to stay smokefree and protect your baby from cigarettes or secondhand smoke. Babies who are exposed to secondhand smoke after birth are more likely to have certain health problems or die from SIDS.

Protect your baby from secondhand smoke by avoiding smoking around your baby, spending time in places that do not allow smoking, and making your house and car smokefree. This is important because babies and young children living in smokefree environments typically have:

• Fewer coughs and chest colds.
• Lower chances of getting bronchitis or pneumonia.
• Fewer ear infections.
• Less frequent and less severe asthma, if they have asthma.
• Fewer missed school days because of asthma attacks and breathing illnesses.
• Less of a chance of becoming smokers as adults.
• Lower chances of dying from SIDS.

Breastfeeding and Smoking

Don’t stop breastfeeding if you smoke. Breastfeeding is good for your baby, so it’s better to do it than not, even if you’re still smoking.

Here’s why breastfeeding is good for both you and your baby:

• Gives your baby nutrients and antibodies that help him or her grow and develop.
• Protects your baby from illnesses, like ear infections and diarrhea.
• Lowers your baby’s risk of diabetes and SIDS.
• Lowers your risk for diabetes, breast cancer, ovarian cancer, and depression.
• Can help you form a special bond with your baby.
• Can help you lose weight during the first year after your baby is born.

Smoking while breastfeeding does expose the baby to nicotine and other harmful substances through breastmilk. If it’s not the right time for you to quit, you can help your baby by following a plan to reduce your baby’s exposure to cigarette smoke.

• Smoke right after breastfeeding and avoid smoking right before. Your body will have more time to clear the nicotine from breast milk.
• Make your house and car smokefree to keep your baby away from secondhand smoke.
• Try cutting down on the number of cigarettes you smoke.
• Don’t smoke while you’re feeding your baby. She or he will inhale your smoke or could get burned by the cigarette.

• Smoking reduces a woman’s chances of getting pregnant.
• Smoking during pregnancy increases the risk for pregnancy complications.
• Tobacco smoke harms babies before and after they are born.

Health Effects of Smoking and Secondhand Smoke on Pregnancies

• Women who smoke have more difficulty becoming pregnant and have a higher risk of never becoming pregnant.
• Smoking during pregnancy can cause tissue damage in the unborn baby, particularly in the lung and brain, and some studies suggests a link between maternal smoking and cleft lip.
• Studies also suggest a relationship between tobacco and miscarriage. Carbon monoxide in tobacco smoke can keep the developing baby from getting enough oxygen. Tobacco smoke also contains other chemicals that can harm unborn babies.

Health Effects of Smoking and Secondhand Smoke on Babies

• Mothers who smoke are more likely to deliver their babies early. Preterm delivery is a leading cause of death, disability, and disease among newborns.
• One in every five babies born to mothers who smoke during pregnancy has low birth weight. Mothers who are exposed to secondhand smoke while pregnant are more likely to have lower birth weight babies. Babies born too small or too early are not as healthy.
• Both babies whose mothers smoke while pregnant and babies who are exposed to secondhand smoke after birth are more likely to die from sudden infant death syndrome (SIDS) than babies who are not exposed to cigarette smoke. Babies whose mothers smoke are about three times more likely to die from SIDS.
• Babies whose mothers smoke while pregnant or who are exposed to secondhand smoke after birth have weaker lungs than other babies, which increases the risk for many health problems.

Smoking anytime during your pregnancy is dangerous. Quitting is the best thing you can do for you and your baby. Here are some common myths about quitting and pregnancy.

Quitting smoking – at any point during your pregnancy – is one of the best things you can do for your baby. Learn how you can become smokefree during your pregnancy and after your baby arrives.

Myths vs. Facts

Myth #1: I’m pregnant and have been smoking, so there is no point in stopping now.

Fact: Quitting smoking at any stage of your pregnancy has health benefits for you and your baby. Even after just one day of not smoking, your baby will get more oxygen. This will help your baby’s lungs develop well. Quitting now also lowers your chances of having a baby with low birth weight.

Myth #2: Quitting smoking will be too stressful on my baby.

Fact: Quitting smoking doesn’t put extra stress on your baby. It’s one of the best things that you can do for your health and your baby’s health during pregnancy—and after the baby is born. By quitting smoking now, you will be protecting your infant from the dangers of secondhand smoke and reducing the risk of sudden infant death syndrome.

Myth #3: Smoking fewer cigarettes or switching to e-cigarettes during pregnancy is OK.

Fact: There is no safe amount of smoking. Every puff of a cigarette releases harmful chemicals that will reach your baby and affect your health too. E-cigarettes are also not harmless. Although there is still much to learn about e-cigarettes, pregnant women should not use them. The nicotine in e-cigarettes is harmful for developing babies.

Myth #4: Smoking relaxes me, and being relaxed is better for me and my baby.

Fact: Smoking may make you feel calmer, but it hurts your body more than it helps. The relaxed feeling is only temporary and whatever is causing your stress will likely return. Smoking speeds up your heart rate and increases your blood pressure. It also increases the carbon monoxide in your bloodstream, which means your baby gets less oxygen.

Myth #5: There is nothing wrong with having a small baby.

Fact: Smoking during pregnancy increases the chances of having a low birth weight baby. Babies with low birth weight are more likely to have serious health problems than normal weight babies. These problems can affect your baby’s health now, throughout their childhood, and into adulthood.

Myth #6: The only way to quit smoking is cold turkey.

Fact: Pregnant women have other ways to quit smoking besides cold turkey, which is quitting without any preparation or counseling. Smokefree Women offers many resources that can help you quit. Try signing up for a text message program, like SmokefreeMom. While some smokers try medications to help them quit, the risks of using them while pregnant are not fully known. If you’re having trouble quitting after trying different methods, be open with your doctor about your challenges and ask if medication may be right for you and your baby.

Myth #7: I smoked during my last pregnancy and had a healthy baby, so this next baby will be healthy, too.

Fact: Every time you smoke during pregnancy, you put your baby’s health at risk. If you smoked and had a healthy pregnancy in the past that does not mean your next one will be healthy, too.

Myth #8: I smoke, so I should not breastfeed my baby.

Fact: According to the American Academy of Pediatrics, mothers who smoke are encouraged to quit smoking, but can breastfeed their baby if they continue to smoke. Breast milk is good for your baby. It provides your baby with what he or she needs for healthy growth and development. Not smoking while you are breastfeeding your baby, waiting to smoke until after you breastfeed, and making your car and home smokefree are important ways to protect your baby from the effects of nicotine and secondhand smoke.

Quitting at any stage of your pregnancy is the best thing that you can do for you and your baby. Being prepared can help you succeed.

Maybe you’re thinking about quitting because you’re trying to get pregnant, or you have a baby on the way. No matter where you are in your pregnancy, it’s never too late to quit smoking. Deciding to quit is the first step to becoming smokefree. Being prepared can keep you moving forward.

Plan to Quit for Good

Many women quit smoking or try to do so while they’re pregnant. Some plan to start smoking again after their baby is born. Quitting smoking during and after your pregnancy can help ensure your baby has the best possible start in life. Keep your baby and yourself safe from the harms of cigarettes and make your pregnancy the start of your smokefree life. To help you prepare and boost your chances of success, build a quit plan today.

Talk to Your Doctor

If you’re pregnant, or are trying to become pregnant, talk to your doctor about quitting. You can begin by being open about your challenges, especially if you haven’t been able to quit in the past. Ask your doctor or pharmacist about local support groups, in-person or telephone counseling, and digital health resources such as smartphone apps or online quitting programs.

Pregnant women are encouraged to try quitting without medications. More research is needed about the medications’ safety and effectiveness for pregnant women. But, if you have not been successful in quitting, ask your doctor if medication is right for you and your baby.

Talk to your doctor before taking any of the following:

• Over-the-counter medications
• Prescription medications (for example: Chantix, Wellbutrin)
• “Herbal products” from health stores

Know What to Do When It Gets Tough

Triggers, cravings, and withdrawal are some of the biggest challenges smokers face when quitting.

• Know what makes you want to smoke and learn ways to avoid these triggers so you can stay smokefree.
• Make a list of things you can do when you’re having a craving. It can set you up for smokefree success.
• Withdrawal symptoms usually last for a few days or weeks. Be prepared to deal by building healthy coping skills, exploring quit methods, or creating an exercise plan.

Practice

It takes most people several tries before they quit for good. Even if you haven’t completely stopped yet, know that every cigarette you don’t smoke is helping you and your baby be healthier. Try a Practice Quit text messaging program and practice quitting for one, three, or five days. You can repeat the program as often as you want to. If you’re ready to quit for a longer time, sign up for SmokefreeMOM.

Explore Quit Smoking Tools

There are many ways to quit smoking – you don’t have to quit cold turkey. Below are free, no-judgment resources that will help you quit.

• Try SmokefreeMOM. This text message program gives 24/7 support to pregnant women. Enter your child’s due date to receive customized messages that match where you are in your pregnancy. Then, choose your goal of the program: to quit smoking or receive messages on smoking and health. You have the option to receive support even if you’re not yet ready to quit permanently. Sign up online or text MOM to 222888 to join now.
• Join the Smokefree Women Facebook page. Women who have quit, or are trying to quit, offer one another advice and inspiration.
• Make your phone your quit buddy. Download quitSTART or QuitGuide, Smokefree’s free smartphone apps. Track your cravings by time and location to help you see patterns so you can stay in control. They also have ways to see your progress and fun distractions to keep you from having a slip.
• Speak with a quit smoking counselor. Call 1-800-QUIT-NOW, or log on to LiveHelp, an online chat service. A trained specialist will give you support and quit smoking information.

Tip: It might take some time to find the quit method that works best for you. If one isn’t working, try something new. Each time you try is a step closer to a smokefree life.

What About E-Cigarettes?

E-cigarettes should not be used during pregnancy. This is because e-cigarettes usually contain nicotine, which can hurt pregnant women and their babies. Nicotine is addictive and can damage a developing baby’s brain and lungs. E-cigarettes may also contain other substances that are harmful to a developing baby, like heavy metals, flavorings, and cancer-causing chemicals.

There is little evidence that e-cigarettes help people quit. Quitting all forms of tobacco products, including e-cigarettes, is best for you and your baby. Talk to your health care provider about proven, safe, and effective quit methods.

Ask for Support

Tell your friends, family, and loved ones that you’re planning to quit smoking for good – for you and the baby. When pregnant women and new mothers get positive support from their loved ones, they’re more likely to successfully quit.

• Explain to them how they can help. Maybe you just need someone to listen. Or maybe you want someone to celebrate with you. Ask them to try to be there for you as much as possible.
• Tell them you may go through mood changes and irritability because of withdrawal. Ask them to be patient and supportive even if you’re in a bad mood.
• Have no smoking rules in your house and car and ask smokers to follow them. Many people say that it’s hard to stay smokefree around people who smoke.

Tip: It’s OK to take a temporary break from people who don’t support your quit. Remember your reasons for quitting and surround yourself with people who will provide positive support and encouragement.

Many women who quit smoking before or during their pregnancy start smoking again after their baby is born. But quitting has benefits for you and your baby that last longer than the nine months you are pregnant.

Why Some Moms Return to Smoking

Most new moms who quit while they’re pregnant will start smoking again within their baby’s first year of life. This is because having a newborn and adjusting to a new routine can be stressful. You are more tired than usual and getting a lot of opinions and advice from others. Stress and emotional triggers can cause new moms to start smoking again. Here are some other reasons why new moms may relapse:

• Quitting was temporary. Some women plan to start smoking after their baby is born. They may think their baby is only at risk while they are pregnant. But even if they smoke away from their baby, chemicals from the smoke can stay in rooms and on clothing.
• Thinking that smoking helps with stress. Having a new baby is stressful, but smoking will not help. Whatever is causing the stress will still be there. There are better ways for new moms to deal with stress that are healthier for you and your baby.
• Wanting to regain their pre-pregnancy self. For some new moms, being a smoker was part of who they were before they got pregnant. After having a baby, they might start smoking again because they miss this part of themselves. Imagining your life as a nonsmoker will help you stay smokefree and will be healthier for you and your baby.
• Returning to old social circles. Some activities and places might remind new moms of smoking. Friends who didn’t smoke around you when you were pregnant may start again and might even offer you a cigarette. Planning on how to deal with others’ smoking can help you stay smokefree.
• Having a partner who smokes. When a partner smokes, the smell of cigarettes, wanting to find ways to be together, and other reminders can make a new mom want to start again. Relationships can play a big role in helping you stay quit.

Make Your Quit Last for Good

Smoking exposes your baby to dangerous secondhand smoke. There is no safe amount of secondhand smoke. It harms a baby’s health and development, and over time it can cause disease and even death. Staying smokefree after delivery will protect you and your child’s health. A healthy baby is a happy baby, which means you can get more sleep, and have more time with your partner and for yourself. Children who grow up in nonsmoking homes are less likely to become smokers, so you will be setting a good example.

There are ways you can stay smokefree after your pregnancy:

• Tell friends and family that you’re planning to stay quit after you give birth.
• Create smokefree zones in your house and car.
• See if nicotine replacement therapy (NRT) is right for you.
• Sign up for a text message program for 24/7 tips, advice, and encouragement.
• Download the QuitGuide or quitSTART apps to track where and when you need extra help to stay smokefree.
• Chat with a National Cancer Institute information specialist for free.
• Call a quitline and speak with a trained counselor.

Outlook for Mother and Baby

Most people know that smoking causes cancer and other major health problems. And smoking while you’re pregnant can cause serious problems, too. Your baby could be born too early, have a birth defect, or die from sudden infant death syndrome (SIDS). Even being around cigarette smoke can cause health problems for you and your baby.

It’s best to quit smoking before you get pregnant. But if you’re already pregnant, quitting can still help protect you and your baby from health problems. It’s never too late to quit smoking.

If you smoked and had a healthy pregnancy in the past, there’s no guarantee that your next pregnancy will be healthy. When you smoke during pregnancy, you put your health and your baby’s health at risk.

How Does Smoking Affect Fertility?

Smoking can cause fertility problems for you or your partner. Women who smoke have more trouble getting pregnant than women who don’t smoke. In men, smoking can damage sperm and contribute to impotence (erectile dysfunction, or ED). Both problems can make it harder for a man to father a baby when he and his partner are ready.

How Can Smoking Harm You and Your Baby?

• Your baby may be born too small, even after a full-term pregnancy. Smoking slows your baby’s growth before birth.
• Your baby may be born too early (premature birth). Premature babies often have health problems.
• Smoking can damage your baby’s developing lungs and brain. The damage can last through childhood and into the teen years.
• Smoking doubles your risk of abnormal bleeding during pregnancy and delivery. This can put both you and your baby in danger.
• Smoking raises your baby’s risk for birth defects, including cleft lip, cleft palate, or both. A cleft is an opening in your baby’s lip or in the roof of her mouth (palate). He or she can have trouble eating properly and is likely to need surgery.
• Babies of moms who smoke during pregnancy—and babies exposed to cigarette smoke after birth—have a higher risk for SIDS.

How Can a Premature Birth Harm Your Baby?

If you smoke during pregnancy, you are more likely to give birth too early. A baby born 3 weeks or more before your due date is premature. Babies born too early miss important growth that happens in the womb during the final weeks and months of pregnancy.

The earlier a baby is born, the greater the chances for serious health problems or death. Premature babies can have:

• Low birth weight
• Feeding difficulties
• Breathing problems right away
• Breathing problems that last into childhood
• Cerebral palsy (brain damage that causes trouble with movement and muscle tone)
• Developmental delays (when a baby or child is behind in language, thinking, or movement skills)
• Problems with hearing or eyesight

Premature babies may need to stay at the hospital for days, weeks, or even months.

How Can Quitting Help You and Your Baby?

The best time to quit smoking is before you get pregnant, but quitting at any time during pregnancy can help your baby get a better start on life. Talk to your doctor about the best ways to quit while you’re pregnant or trying to get pregnant.

When you stop smoking:

• Your baby gets more oxygen, even after just 1 day.
• Your baby will grow better.
• Your baby is less likely to be born too early.
• You’ll have more energy and breathe more easily.
• You will be less likely to develop heart disease, stroke, lung cancer, lung disease, and other smoking-related diseases.

Support for Quitting During Pregnancy

Most pregnant women who smoke want to quit, but quitting isn’t always easy during pregnancy. What’s more, if you’re pregnant and still smoking, you may feel ashamed and alone.

The right kind of support can help a pregnant woman get through the unique challenges of quitting during this phase of life. Special guidance is available for you and the people around you.

Quitting smoking to protect the health of you and your baby is one of the most important things you can do. If you are pregnant or planning to get pregnant, talk to your doctor or call 1-800-QUIT-NOW to get started.

Stay Smokefree for a Healthy Child

Staying smokefree is important. Tobacco smoke contains a deadly mix of more than 7,000 chemicals. When your child is not exposed to smoke, you can expect him or her to have:

• Fewer coughs and chest colds
• A lower risk for bronchitis or pneumonia (lung problems)
• Fewer ear infections
• Fewer asthma attacks and wheezing problems