Smoking in pregnancy – supporting you to quit for the best start for you and your baby
Read our guide below about how to quit smoking in pregnancy.
You can also download a PDF version of this patient information by following the link on the right.
This information is for you if you smoke, and are already pregnant, or you’re thinking about having a baby. It’s also for you if you’re:
- exposed to tobacco smoke at home
- the partner or relative of a woman who smokes.
Many women find it difficult to stop smoking, but it’s one of the most important things you can do to improve your baby’s health, growth and development. It’s also the single most important thing you can do to improve your own long-term health.
It’s never too late to stop smoking. When you stop smoking, you and your baby will feel the benefits immediately.
Why is smoking harmful to me and my baby?
Tobacco smoke reduces the amount of oxygen and nutrients that pass through the placenta from you to your baby.
Smoking when you’re pregnant increases the risk of:
- miscarriage
- ectopic pregnancy
- premature birth (when your baby is born before 37 weeks of pregnancy)
- placental abruption (when the placenta comes away from the wall of the womb) and bleeding during the last months of pregnancy – this can be life threatening for you and your baby.
It also increases the risk of your baby:
- dying in the womb (stillbirth) or shortly after birth. Smoking is thought to be the cause of death in 1/3 of these cases
- being born with abnormalities and defects such as cleft palate
- having health and growth problems – the more you smoke, the less healthy your baby will be. A baby that is small due to smoking is more likely to have health
problems in later life.
What problems could my baby have after they’re born and in later life?
Babies and children whose mothers smoke during pregnancy are at a greater risk of:
- sudden and unexplained death, known as Sudden Infant Death Syndrome (SIDS, or “cot death”). The risk is greater if you or your partner continue to smoke after the baby’s born, particularly if you bed-share
- asthma, chest and ear infections, and pneumonia
- behavioural problems such as ADHD (attention deficit hyperactivity disorder) and performing poorly at school.
Stopping smoking reduces all of these risks.
What about second-hand (passive) smoke?
If your partner or someone you live with smokes, their smoke will affect you and your baby before and after their birth. You may also find it harder to stop smoking if someone around you smokes.
Second-hand smoke can also reduce your baby’s birthweight and increase the risk of SIDS.
Babies whose parents smoke are more likely to be admitted to hospital for bronchitis and
pneumonia during their first year.
See below for information on the stop smoking support available for your partner.
Will I be asked about smoking when I’m pregnant?
Yes. From your first antenatal appointment, your midwife will ask whether you or any other member of the household smokes. This is important so that you and your family can get support and help to stop smoking as early as possible.
We’ll ask you how often you smoke and how much tobacco you smoke per day.
We’ll give you information about how smoking and passive smoking harms you and your baby. To help you stop smoking and give you and your baby the added benefits of a smoke free pregnancy, we refer all women who smoke to our in-house stop smoking service.
At every midwife appointment, we’ll ask you how often you smoke and how much tobacco you smoke per day. This ensures you’re getting the right level of support to stop smoking.
What is the carbon monoxide (CO) test?
We advise all pregnant women, whether they smoke or not to have a breath test at every midwife appointment. This measures the level of exposure to CO.
CO is a poisonous gas that restricts the amount of oxygen getting to your baby. CO levels are higher in women who smoke or are passive smokers, than in women who don’t.
Levels may also be high if you:
- have faulty gas appliances at home
- are exposed to high levels of pollution
- have an intolerance to lactose.
CO poisoning can be fatal. If you don’t smoke and you’re not exposed to tobacco smoke but your levels are high, contact the free Health and Safety Executive Gas Safety Advice Line on 0800 300 363.
I’m a smoker, what should I do?
There’s no safe level of smoking for you or your baby. The earlier you stop smoking, the greater the benefit to you and your baby but it’s important to know that stopping at any time during pregnancy is beneficial to some extent.
Reducing the number of cigarettes you smoke is a positive step although there’s no evidence that this is better for your baby. For this reason, both you and your partner must stop completely rather than just cut down.
How can you support me to quit smoking?
We have an in-house Stop Smoking Service in the maternity unit. You can see a tobacco dependency advisor (TDA) who is specifically trained and experienced in supporting pregnant women to stop smoking.
How do I get an appointment with the TDA?
They’ll contact you shortly after your first antenatal appointment to offer personalised stop-smoking support. TheTDA understands how difficult quitting smoking can be and are trained in supporting positive behaviour change. The TDA will discuss the barriers you may have as well as techniques to overcome these.
Appointments are over the telephone or face-to-face, depending on your individual needs and preferences. The TDA can also provide stop smoking aids to those who engage with the service as these make quitting smoking more likely.
If you opt out of this service, you can re-engage with our TDA at any time in your pregnancy
You can self-refer into the service by emailing bht.maternitystop-smoking@nhs.net or ask your midwife to re-refer you to the TDA.
Nicotine Replacement Therapy (NRT)
You can use NRT during pregnancy if it will help you stop smoking and you can’t stop without it. NRT contains only nicotine and none of the damaging chemicals found in cigarettes, so it’s a much better option than continuing to smoke. It helps you by giving you the nicotine you would have had from a cigarette.
The TDA can provide NRT during pregnancy. It’s available as patches, gum, lozenges, and an inhalator nasal spray. Alternatively, your GP can prescribe it for you or you can buy it over the counter without a prescription from a pharmacy.
Stop smoking tablets such as Zyban are not recommended during pregnancy.
You’re 3 times more likely to quit smoking for good if you use a combination of treatment (such as NRT) and specialist stop smoking support.
E-cigarettes and vaping
An e-cigarette is an electronic device that delivers nicotine in a vapour rather than smoke. This allows you to inhale nicotine without most of the harmful effects of smoking, as the vapour contains no tar or carbon monoxide.
E-cigarettes are fairly new, and there has not been much research into the safety of e- cigarettes in pregnancy or long-term effects. However, current evidence on e-cigarettes indicates they’re much less risky than smoking and are effective in helping people quit smoking.
You may want to try them instead of the medicines listed above.
As with other approaches, they’re most effective if used with support from an NHS stop smoking service.
More support
Get advice on how to quit smoking from the NHS
Call the National Smokefree helpline on 0300 123 1044 (9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday).
Get help to quit smoking from Be Healthy Bucks
You and your partner can sign up for 8 to 12-weeks’ tailored support if you’re registered with a GP in Buckinghamshire. Trained health and wellbeing coaches offer digital, telephone or face to face support, as well as stop smoking aids so you can be smoke free. Sign up now