Smoking and pregnancy

“When you smoke, so does your baby...” There is no safe level of smoking, either for you or your baby.

Smoking during pregnancy exposes your unborn baby to over 7000 chemicals contained in cigarette smoke. Pregnancy is a great time for you to quit smoking.

How smoking affects pregnancy?

Smoking while you are pregnant can cause problems for both mum and baby. It increases your risk of:

  • miscarriage
  • ectopic pregnancy (foetus develops outside the womb)
  • bleeding during the last months of pregnancy, which can be life-threatening for you and your baby
  • premature labour (start before 37 weeks) 
  • your baby dying in the womb (also called stillbirths) or shortly after birth
  • your baby being born with abnormalities such as cleft lip or cleft palate.

Smoking affects the growth of babies in the womb. It reduces the supply of oxygen and nutrients that pass through the placenta, from you to your baby. Babies born to mothers who smoke typically weigh less than infants born to women who do not. Smaller babies do not mean a shorter or easier labour. 

The long-term effects

The effects of smoking on your unborn baby can have long-term effects on their growth and development. Babies and children whose mothers smoke during pregnancy have a greater chance of:

How to quit?

It's never too late to quit smoking. Stopping anytime during your pregnancy has great benefits for you and your baby. The earlier you stop smoking, the greater the benefit. Giving up smoking is difficult – there are many ways to get help and support.

Tips for quitting

  • Change your routine and habits. For example, if drinking tea and coffee are difficult times, try drinking mainly fruit juice and plenty of water.
  • Make a list of all the reasons why you want to stop, and keep it with you. Refer to the list when you are tempted to light up. Read more: why quit smoking.
  • Avoid situations that make you want to smoke – for example, the pub.
  • Be prepared for some withdrawal symptoms. When you stop smoking, you are likely to get symptoms which may include feeling sick (nausea), headaches, anxiety, irritability, craving, and just feeling awful. These symptoms are caused by the lack of nicotine that your body has been used to. They tend to peak after 12-24 hours and then gradually ease over 2-4 weeks.
  • Remember the 4 Ds if you get cravings: Delay, Drink water, Deep breathe, Do something else. Keep yourself busy. 
  • Make your home smoke-free and get rid of ashtrays. Wash all your 'smoky' clothes and furnishings.
  • Brush your teeth with a fresh minty toothpaste. Book into your dentist to have your teeth cleaned.
  • Take one day at a time. Mark off each successful day on a calendar. Look at it when you feel tempted to smoke, and tell yourself you don't want to start all over again.
  • Be positive. You can tell people that you don't smoke. You will smell better. After a few weeks you should feel better, taste your food more, and cough less. You will have more money.
  • Food. Some people worry about gaining weight when they give up smoking, as the appetite may improve. Anticipate an increase in appetite and try not to increase fatty or sugary foods as snacks. Try fruit and sugar-free gum instead.
  • Reward yourself with a treat from some of the money you've saved. Do things you enjoy – give yourself treats
  • Don't despair if you fail and have a cigarette. You don't have to start smoking again. Pick yourself up and try again. Consider the reasons why you felt it was more difficult at that particular time. It will make you stronger next time.

Dedicated smoking cessation services for pregnant women

If you wish to stop smoking, your lead maternity provider will refer you to a dedicated smoking cessation service for support, such as:

Support of family and friends

Reach out to your partner, family and friends. It's helpful having someone to call to keep you motivated when you have those strong urges and cravings. Your partner or other close family members and friends who smoke can support you by quitting too. It is helpful if you are around others who do not smoke.    

Medications

Nicotine replacement therapy (NRT) is a safe and effective way of administering nicotine to manage your cravings, without all the other harmful chemicals contained in cigarette smoke.

  • In pregnant women, who are 'light' smokers and are confident they can stop without medication, quitting without NRT is preferable. But, for women who are pregnant or breastfeeding and unable to stop smoking on their own, NRT can be used.
  • When using NRT, you and your baby are still exposed to nicotine, but the nicotine is delivered at lower levels than smoking, without all the other harmful chemicals contained in cigarette smoke. 
  • NRT medications are available in different forms such as chewing gum, lozenges or skin patches.  
  • For pregnant women, it is preferable to use gum or lozenges compared with patches as this provides a lower daily dose of nicotine. But, if the gum or lozenges are not sufficient, then a shorter-acting 16-hour patch can be used together with the gum or lozenges. Remember to remove the patch before going to bed. If you use NRT together with support from your healthcare provider, family or whanau, you're 4 times more likely to quit.
  • NRT is fully subsidised at a cost of $5 for a 3-month supply. It can be prescribed by your doctor and midwives. It is also available from Quitline and Quit Card providers. Some patients with a community services card may receive an additional subsidy. Unsubsidised NRT is also sold over the counter at pharmacies or supermarkets. 

Are E-cigarettes safe?

Electronic cigarettes (also called E-cigarettes) are battery-operated cigarettes that turn chemicals, including nicotine, into vapour, which is then inhaled. They are becoming a popular alternative to smoking. Currently, the Royal College of Midwives (UK) recommends E-cigarettes over continuing to smoke. Read more E-cigarettes in pregnancy.

Learn more

I quit smoking for baby and me HPA, Quitline (NZ) 
Smoking and pregnancy The Quit Group (NZ)
Smoking and pregnancy Royal College of Obstetricians and Gynaecologists (UK)

References

  1. Encouraging smoke-free pregnancies: the role of primary care  BPAC, Feb 2013
  2. Smoking and pregnancy Royal College of Obstetricians and Gynaecologists (UK)
  3. Tips for quitting Quitline, NZ
  4. E-cigarettes Ministry of Health, NZ  
Credits: Health Navigator Editorial Team. Last reviewed: 08 May 2017