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Pregnant how to quit smoking


Stop smoking in pregnancy - NHS

Smoking and your unborn baby

Protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. It can be difficult to stop smoking, but it's never too late to quit.

Every cigarette you smoke contains over 4,000 chemicals, so smoking when you are pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby. As a result, their heart must beat harder every time you smoke.

Benefits of stopping smoking in pregnancy

Stopping smoking will help both you and your baby immediately. Harmful gases, such as carbon monoxide, and other damaging chemicals will clear from your body. When you stop smoking:

  • you will reduce the risk of complications in pregnancy and birth
  • you are more likely to have a healthier pregnancy and a healthier baby
  • you will reduce the risk of stillbirth
  • your baby is less likely to be born too early and have to face the breathing, feeding and health problems that often go with being premature
  • your baby is less likely to be born with a low birth weight. Babies of smokers are, on average, 200g (about 8oz) lighter than other babies, which can cause problems during and after labour. For example, they are more likely to have problems keeping warm and are more likely to get infections
  • you will reduce the risk of sudden infant death syndrome (SIDS), also known as "cot death".

Stopping smoking now will also help your baby later in life. Children whose parents smoke are more likely to suffer from asthma and other serious illnesses that may need hospital treatment.

The sooner you stop smoking, the better. But even if you stop in the last few weeks of your pregnancy this will benefit you and your baby.

Secondhand (passive) smoke harms your baby

If your partner or anyone else who lives with you smokes, their smoke can affect you and your baby before and after their birth. You may also find it more difficult to stop if someone around you smokes.

Secondhand smoke can also reduce your baby's birthweight and increase the risk of sudden infant death syndrome (SIDS), also known as "cot death". Babies whose parents smoke are more likely to be admitted to hospital for bronchitis and pneumonia during their first year.

To find out more about quitting and to get support, your partner can call the NHS Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

Nicotine replacement therapy

You can use nicotine replacement therapy (NRT) during pregnancy if it will help you stop smoking and you're unable to stop without it. It's not recommended that you take stop smoking tablets such as Champix or Zyban during pregnancy.

NRT contains only nicotine and none of the damaging chemicals found in cigarettes, so it is a much better option than continuing to smoke. It helps you by giving you the nicotine you would have had from a cigarette.

You can be prescribed NRT during pregnancy by a GP or an NHS stop smoking adviser. You can also buy it over the counter without a prescription from a pharmacy.

NRT is available as:

  • patches
  • gum
  • inhalator
  • nasal spray
  • mouth spray
  • oral strips
  • lozenges
  • microtabs

If you have pregnancy-related nausea and vomiting, patches may be a better solution.

NRT patches should be used for no more than 16 hours in any 24-hour period. The best way to remember this is to remove the patch at bedtime.

Before using any of these products, speak to a midwife, GP, a pharmacist or a specialist stop smoking adviser.

By getting this specialist advice you can be sure that you're doing the best for your baby and for you.

Call the NHS Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

Remember, you are twice as likely to be successful at quitting if you get some support from a trained adviser.

Liquorice-flavoured nicotine products

Pregnant women are advised to avoid liquorice-flavoured nicotine products. Although there is no known risk with small amounts of liquorice flavouring, the manufacturers advise caution.

This caution is based on information about the adverse effects associated with excessive amounts of liquorice root. As other flavours are available, pregnant women are advised to choose an alternative, such as fruit or mint.

Find out more about stop smoking treatments.

E-cigarettes in pregnancy

E-cigarettes are fairly new and there are still some things we do not know. However, current evidence on e-cigarettes indicates they are much less risky than smoking.

Cigarettes deliver nicotine along with thousands of harmful chemicals. E-cigarettes allow you to inhale nicotine through a vapour rather than smoke. By itself, nicotine is relatively harmless.

E-cigarettes do not produce tar or carbon monoxide, the 2 main toxins in cigarette smoke. Carbon monoxide is particularly harmful to developing babies. The vapour from an e-cigarette does contain some of the potentially harmful chemicals found in cigarette smoke, but at much lower levels.

If using an e-cigarette helps you to stop smoking, it is much safer for you and your baby than continuing to smoke.

Unlike nicotine replacement therapy (NRT), such as patches or gum, e-cigarettes are not available on an NHS prescription. If you want to use an e-cigarette, you can still get free expert help from a stop smoking adviser.

Call the NHS Smokefree helpline on 0300 123 1044 for more information, or ask a midwife to refer you.

Find out more about using e-cigarettes to stop smoking.

NHS Smokefree helpline

The NHS Smokefree helpline offers free help, support and advice on stopping smoking and can give you details of local support services.

You can also sign up to receive ongoing advice and support at a time that suits you.

Information:

NHS Smokefree helpline: 0300 123 1044

9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

To find your nearest NHS Stop Smoking service talk to:

  • a midwife
  • a health visitor
  • a nurse at your GP surgery
  • a pharmacist

NHS Stop Smoking services can offer 1-to-1 or group sessions with trained stop smoking advisers and may have a pregnancy stop smoking specialist.

They can also offer advice about dealing with stress, weight gain and support the use of NRT (such as patches or gum), if appropriate, to help you manage your cravings.

Find out more about the effects of smoking in pregnancy, and getting support to quit, at Start4Life.

Find more advice on how to stop smoking.

Find stop smoking services near you.

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Video: should I give up smoking?

In this video, a midwife explains how smoking can harm your baby.

Media last reviewed: 5 February 2020
Media review due: 5 February 2023

Myths: Smoking and Pregnancy | Smokefree

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.

Smoking during pregnancy

SMOKING DURING PREGNANCY: SHOULD I QUIT?

There are more smoking pregnant women than it might seem, but almost everyone hides this moment of their weakness, so there are very few who want to participate in medical research. But this does not negate the fact that nicotine addiction poses a threat to the child on all fronts - from intrauterine development to complications during childbirth and even future mental development.

Let's make a reservation right away that exact statistics on this issue still do not exist for a simple reason - it is very difficult for researchers to cover a sufficient number of participants to draw categorical conclusions.

For medical professionals, the negative impact of tobacco smoke on pregnancy is obvious, but among smokers, talk continues that this is an exaggeration.

Sometimes you can hear examples, they say, smoked, gave birth - and that's okay. The reason for such an unreasonably easy attitude of expectant mothers to smoking is that there really are no absolute guarantees of the harm of nicotine. But of course, you understand that even the existing risk is already a reason to refuse substances that can harm the fetus.

​

HOW SERIOUS IS SMOKING IN PREGNANCY?

It would seem that the question is rhetorical. And yet, many women believe that the consequences of addiction are either greatly exaggerated, or by some miracle will not affect them at all. Moreover, on the network on the forums, you can come across the opinion that it is absolutely impossible for a smoker to quit on time (it’s hard to understand why), there are even links to advice from gynecologists-obstetricians who do not recommend quitting!

It is up to you to decide how to deal with such claims, but keep in mind that for more than 50 years, medicine has been studying the negative effects of tobacco on the body, and by no means in favor of the latter.

Remember that tobacco companies don't sell you health, they advertise a way to keep yourself busy, relax or get together, a stylish look with a cigarette in your mouth and other ephemeral things.

On the other hand, the truth is that smoke brings toxins into the body, which take enormous resources every day to neutralize - blood, liver, lung cells, hemoglobin, brain neurons, and so on.

If you like to inhale smoke, okay, there's no arguing about taste, but doesn't your pregnancy require all the internal reserves from you to ensure the normal development of the fetus in the womb and a successful birth with subsequent feeding? Wasting what rightfully belongs to the little being inside of you is probably cruel and unwise.

Let us recall some consequences of smoking during pregnancy:

  • the supply of oxygen from maternal blood to the fetus is reduced;

  • nicotine constricts peripheral vessels;

  • blood flow changes abnormally for 20-30 minutes after each cigarette;

  • the accumulation of carbon dioxide in the body negatively affects the composition of the blood of a pregnant woman;

  • the baby's heart in the womb begins to beat faster, tachycardia causes weight loss of both the expectant mother and the child inside, which can be born with underweight and poor vitality;

  • liver cells work hard to remove toxins from the blood, overstrain of the vessels of this organ and its ducts causes excruciating gastritis;

  • hemoglobin drops from stomach problems - the child does not receive enough nutrition in the womb;

  • The still developing fetal brain suffers, the normal number of its cells is reduced, other important organs are formed incorrectly;

  • in special cases, when the mother did not let the cigarette out of her mouth until the very birth, the newborn gets a ready addiction to nicotine, although he himself has never smoked!

Among the mildest consequences, let's mention at least the fact that the children of smokers are restless and constantly cry and scream. Whoever thinks that this is not a problem simply does not know what the price of an infant's cry is - from loss of consciousness in mothers who have not slept for a week to a hernia in the babies themselves.

Such consequences as congenital heart disease, underdevelopment of tissues of internal organs and skeleton with muscles (“cleft lip”, “cleft palate”) are considered severe. These troubles happen without cigarettes, but with them the risk increases incredibly!

So, if you have a bad habit and weak nerves, you probably think that the “withdrawal syndrome” of nicotine and the psychological discomfort from it during pregnancy will bring you suffering and harm.

Think rationally: what are you more afraid of - your irritability and dry mouth when you want to smoke, or the problems described above in your future son or daughter? The answer is obvious, right?

​

HOW DOES SMOKING CANNABIS DURING PREGNANCY AFFECT

For example, those women who do not smoke tobacco sometimes indulge in the use of other substances. There is nothing wrong, they say, to sometimes relax with "weed", especially since everyone knows about its medical use, but ...

Smoking marijuana during pregnancy jeopardizes the future mental abilities of the baby! The psychoactive substance (tetrahydrocannabinol) quickly penetrates into the blood of the future mother, and about 10% of its content enters the bloodstream of the fetus through the placenta.

At the same time, using marijuana and protecting an unborn child will not work - everything that is in the mother's blood will be in the child. At the same time, the risk of developing a convulsive syndrome in a newborn is high, and then - from underweight and asthma to severe genetic disorders. Pregnant women should give up bad habits and addictions as soon as they find out about their new position.

​

HAZARDS OF PASSWORD SMOKE DURING PREGNANCY

The widespread occurrence of this habit has led us to the fact that in almost every family someone smokes, which means that other family members are under the threat of passive smoking:

  • passive inhalation of cigarette smoke is almost equal to the use of cigarettes by a smoker;

  • one hour spent in a smoky room produces the same effect on the body as one and a half smoked cigarettes;

  • it is impossible to live in an apartment with a smoker and it is impossible to avoid the influence of smoke - the combustion products contained in the smoke are absorbed into furniture, wallpaper, things and for years (!) release toxins into the environment of the whole family;

  • passive smokers do not receive the same dose of nicotine as active smokers, but suffer much more from tar and toxic substances from the smoke;

  • 90,002 non-smoking women in the same apartment with a smoker are at risk of earning breathing problems, anemia, runny nose, lethargy and muscle aches, and pregnant women - increased toxicosis.

The terrible thing is that the smoke from the air penetrates into the lungs and from there into the blood, even at a minimal concentration. The liver of a pregnant woman is already under stress, as are the cardiovascular and nervous systems, and then there is such a blow in the form of “exhaust gases” from cigarettes. If you are waiting for replenishment, and tobacco clouds envelop you at home, fight it immediately!

Demand respect for yourself and your baby, if necessary - defend your right to clean air firmly and uncompromisingly. It is better to make a good scandal and forbid smoking in the apartment than to suffer in silence and put yourself in danger of a miscarriage.

Tobacco addicts can be your problem in another way. Passive inhalation of smoke for former smokers becomes the factor due to which they again take up a cigarette - secretly, a little bit, "one puff."

Not everyone understands that it is very difficult for women to give up their addiction if their husband does not do it. This moment is very important both psychologically and physically. Foreign smoke not only irritates and causes nausea, but also encourages cravings for the forbidden cigarette. Therefore, if you quit for the sake of the unborn child, then all together.

Smoking during pregnancy is a habit that can cost you dearly, and you will have to pay with the health of your child. The well-being of the baby is worth the effort to overcome nicotine addiction and avoid relapses, remember - now you are a mother, and this involves a lot of responsibility!

UK Best Practices - Practical Health Psychology

Felix Naughton, University of East Anglia, UK

Between 25 and 50% of women who smoke quit smoking after discovering they are pregnant. But why do others continue to smoke throughout pregnancy?

Don't they know that smoking during pregnancy is bad? This is usually the case. One of our UK studies of pregnant women, both motivated and unmotivated to quit smoking, found that 99% agree to some extent with the statement "smoking during pregnancy can seriously harm my baby" and about 75% agree very or very strongly. However, 12 weeks later, less than 10% of them abstained. Although quitting is more likely for those who strongly believe that smoking during pregnancy is "dangerous", this does not seem to increase the chances of success.

Summary : beliefs about the dangers of smoking during pregnancy play only a minor role.

Are they not motivated to quit smoking? In some cases this is true. According to our research, in early pregnancy, just under half of women report an intention to quit smoking within the next 30 days, and about the same number of women attempt to quit smoking. As the pregnancy progresses, the motivation to quit smoking decreases. Surprisingly, motivation does not increase the chances of success in quitting smoking itself. The same is true among non-pregnant smokers. In addition, reviews of randomized controlled trials evaluating interventions through motivational interviewing, a counseling approach aimed in part at helping people increase their motivation to change behavior, show that this approach is not effective in terminating a pregnancy.

Summary : Motivation increases the chances that a woman will try to quit smoking, but by itself it is not enough to lead to complete abstinence.

Are they not interested in helping you quit smoking? Again, this is true in some cases, but not in all. We found that about half of pregnant women want help to quit smoking early in their pregnancy. In contrast to motivation, the level of interest in support persisted into late pregnancy. However, only about one in ten reported accessing standard smoking cessation support at any time during pregnancy. Those who have done so have reported an increased interest in it in early pregnancy. Talking to a health care provider about quitting smoking was closely linked to an interest in getting support, so this can be an easy way to expand access to help.

Summary : Talking to a pregnant woman about quitting may increase her interest in support, which in turn may increase her chance of accessing it.

There are no effective ways to help pregnant women? Fortunately, there is. Research has shown that behavioral support, structured advice, and behavioral management assistance for smoking and quitting (but not motivational interviewing), whether delivered individually or through self-help, print or digital resources, can help pregnant women. Women quit smoking. Adding nicotine replacement therapy (NRT) to behavioral support for women with moderate or severe nicotine dependence is likely to increase the effectiveness of the support. However, the evidence is rather weak, most likely because many studies report poor adherence to NRT. This is partly due to concerns that nicotine is harmful to the baby. However, a review of the highest quality studies involving tens of thousands of women and infants found that there is no evidence of harm from using NRT during pregnancy. Based on this, women can be sure that any risks of using NRT are lower compared to continuing to use tobacco. A lesser known factor is that pregnant women break down nicotine in their bodies twice as fast as when they are not pregnant due to increased metabolism. This means that pregnant women will need more NRT than usual to reduce food cravings and withdrawal symptoms. However, as a general rule, women and practitioners prefer to use less NRT than usual.

Other forms of nicotine delivery, such as e-cigarettes, may be as effective during pregnancy as outside of pregnancy, but we do not currently have evidence to support their recommendation. The harm from e-cigarettes is likely to be significantly less than from tobacco. If pregnant women want to use e-cigarettes to help them quit smoking, the advice in the UK is to support them in doing so. Another effective approach is to provide financial incentives to achieve abstinence if provided along with behavioral support. Evidence shows that incentives are the most effective approach we know of.

Summary : Behavioral support, especially when combined with nicotine replacement therapy for those who exhibit nicotine addiction and/or financial incentives, is effective.

Who needs support the most? Smoking cessation during pregnancy is associated with many factors, such as low education or income. But more important from a practical point of view, having a partner who smokes and having a moderate to high degree of nicotine addiction are major barriers to quitting for many women. Other factors are depression and increased stress during pregnancy.

Summary : Women with one or all of these characteristics are likely to need intensive and multicomponent support.

Practical advice