Smoking during pregnancy

How is smoking harmful to your body?

Cigarettes and cigars are made from tobacco leaves. Tobacco contains a drug called nicotine. Nicotine is what makes you become addicted to smoking. Addiction is a brain condition that makes you smoke, even if you don’t want to. Addiction affects your self-control and your ability to stop smoking. 

Smoke from tobacco contains more than 7,000 chemicals. At least 250 of these are harmful to smokers and nonsmokers. At least 69 of them can cause cancer. Breathing even a little tobacco smoke can be harmful.

Smoking harms nearly every organ in the body. It can cause serious health conditions, including:

• Addiction
• Cancer of the lung, mouth, throat, kidneys and other organs. It also causes cancer of the blood (also called leukemia).
• Heart disease and lung disease
• Diabetes
• Stroke. This is when a blood clot blocks a blood vessel that brings blood to the brain, or when a blood vessel in the brain bursts open.
• Gum disease
• Eye problems that can lead to blindness

How can smoking harm your pregnancy?

Smoking during pregnancy is bad for you and your baby. Quitting smoking, even if you’re already pregnant, can make a big difference in your baby’s life.

If you smoke during pregnancy, you’re more likely than nonsmokers to have:

• Preterm labor. This is labor than starts too early, before 37 weeks of pregnancy. Preterm labor can lead to premature birth. Babies born prematurely are more likely to have health problems at birth and later in life than babies born on time. 
• Ectopic pregnancy. This is when a fertilized egg implants itself outside of the uterus (womb) and begins to grow. An ectopic pregnancy always ends in pregnancy loss. It can cause serious, dangerous problems for a pregnant woman. Most of the time, ectopic pregnancies are removed by surgery.
• Bleeding from the vagina
• Problems with the placenta, like placental abruption and placenta previa. The placenta grows in your uterus and supplies the baby with food and oxygen through the umbilical cord. Placental abruption is a serious condition in which the placenta separates from the wall of the uterus before birth. Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina.

If you smoke and are pregnant or thinking about getting pregnant, tell your provider. Your provider can help you quit.

How can smoking affect your baby?

When you smoke during pregnancy, chemicals like nicotine, carbon monoxide and tar pass through the placenta and umbilical cord to your baby.

These chemicals are harmful to your baby. They can lessen the amount of oxygen that your baby gets. This can slow your baby’s growth before birth and can damage your baby’s lungs and brain.

If you smoke during pregnancy, your baby is more likely to:

• Be born prematurely, before 37 weeks of pregnancy
• Have birth defects, including birth defects in a baby’s mouth called cleft lip or cleft palate. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works.
• Have low birthweight. This means your baby is born weighing less than 5 pounds, 8 ounces.
• Die before birth from miscarriage or stillbirth. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy.
• Die of sudden infant death syndrome (also called SIDS). SIDS is the unexplained death of a baby younger than 1 year old. SIDS usually happens when a baby is sleeping. It’s sometimes called crib death because the baby often dies in his crib.

If you smoke and are pregnant or thinking about getting pregnant, tell your provider. Your provider can help you quit.

What is secondhand smoke?

Secondhand smoke is smoke you breathe in from someone else’s cigarette, cigar, pipe or other tobacco product. Secondhand smoke is dangerous for you and your baby. Being around secondhand smoke during pregnancy can cause your baby to be born with low birthweight or birth defects.

Secondhand smoke also is dangerous to your baby after birth. Babies exposed to secondhand smoke are more likely than babies who aren’t to die of SIDS. They’re also at risk for health problems like:

• Asthma. This is a health condition that affects the body’s airways and can cause breathing problems.
• Bronchitis. This is inflammation (irritation, like redness and swelling) in the bronchial tubes that carry air to and from your baby’s lungs. It can cause coughing and shortness of breath.
• Ear infections
• Pneumonia. This is an infection in the lungs.

What is thirdhand smoke?

Thirdhand smoke is what’s left behind when someone smokes. It’s what you smell on things like clothes, furniture, carpet, walls, skin and hair that’s been in or around smoke. Thirdhand smoke sticks to these things, builds up over time and is hard to remove. Thirdhand smoke is why opening a window or smoking in another room isn’t enough to protect others when you smoke.

Thirdhand smoke contains more than 250 chemicals and is harmful to pregnant women, babies and children. Babies and children can be exposed to these chemicals when they breathe in thirdhand smoke or when they touch or put things in their mouth that have been exposed to thirdhand smoke. Researchers are working to find out if thirdhand smoke causes cancer and other serious health problems.

What are e-cigarettes?

Electronic cigarettes (also called e-cigarettes) contain liquid that usually includes nicotine, flavors (like strawberry, cinnamon or bubble gum) and other chemicals. Some look like regular cigarettes. Some look like pens, computer memory sticks or asthma inhalers. Instead of lighting e-cigarettes, they run on batteries. Other names for e-cigarettes are e-cigs, e-hookahs, hookah pens, vapes, vape pens, tank systems and mods.

When you use an e-cigarette, you puff on a mouthpiece to heat up the liquid. This creates a mist (also called vapor) that you inhale. Using an e-cigarette is called vaping or Juuling (JUUL is the name of one kind of e-cigarette). Just like with regular cigarettes, you can become addicted to e-cigarettes that contain nicotine.

The different flavors of e-cigarettes may make them seem fun and appealing, especially to children. If you drink or touch the liquid in e-cigarettes, it can cause nicotine poisoning. Nicotine poisoning can be deadly. Signs and symptoms of nicotine poisoning include:

• A fast or slow heartbeat
• Belly cramps
• Breathing problems
• Headache
• Vomiting

If you think you have nicotine poisoning, call emergency services (911) or Poison Control (800-222-1222) right away.

Is it safe to use e-cigarettes during pregnancy?

No. E-cigarettes contain chemicals, like nicotine, that can harm you and your baby. Flavors and other chemicals in e-cigarettes may be harmful to you and your baby. Breathing in someone else’s e-cigarette vapor also may be harmful. More research is needed to better understand how e-cigarettes affect women and babies during pregnancy.

If you’re pregnant and using e-cigarettes, talk to your health care provider about quitting.

Can you just cut down on smoking? Or do you have to quit?

You may think that light or mild cigarettes are safer choices during pregnancy. This is not true. Or you may want to cut down rather than quit smoking altogether. It’s true that the less you smoke, the better for your baby. But quitting is best. 

The sooner you quit smoking during pregnancy, the healthier you and your baby can be. It’s best to quit smoking before getting pregnant. But quitting any time during pregnancy can have a positive effect on your baby’s life.

On average, smokers die 10 years earlier than nonsmokers. Quitting smoking reduces your risk of cancer and other diseases, like heart disease. When you quit smoking, you never have to go outside and look for a place to smoke. And quitting smoking can help you have: 

• Cleaner teeth, fresher breath and a better sense of taste
• Fewer stains on your fingers
• Fewer skin wrinkles
• Better vision
• Stronger muscles and bones
• More energy to be more active

If you need help to quit smoking, tell your health care provider.

What are some tips to help you quit smoking?

Making a quit plan is a great way to help you quit smoking. A quit plan is a personalized plan that can help you get ready to quit. It also can help increase your chances of quitting and staying smoke-free. Visit smokefree.gov/build-your-quit-plan to get your plan started. Or write your plan on paper. Here are some things to include:

• A quit day. On this day, throw away all your cigarettes or cigars, lighters and ashtrays. Choose a day within the next 2 weeks so you have time to get ready. Put the quit day in your calendar.
• Your reasons for quitting. Look at the list when you think about smoking.  
• Triggers that make you want to smoke. Triggers can be emotional, like wanting to smoke when you feel stressed or lonely. They can be activities that make you want to smoke, like talking on the phone or finishing a meal. Or they can be social events, like going to a party or bar. Knowing what your triggers are can help you learn ways to manage them so you don’t need to smoke.
• Ways to deal with cravings. For example, what can you do instead of smoking when you have a craving to smoke. For example, go for a walk to help keep your mind off smoking. Use a small stress ball or try some needlework to keep your hands busy. Snack on veggies or chew gum to keep something in your mouth. 
• Get rid of smoking reminders, like matches and ashtrays. Wash your clothes and clean your car.
• Tools to help you quit. Ask your health care provider about things to help you quit, like patches, gum, nasal spray and medicines. Don't start using these without your health care provider's OK, especially if you're pregnant. Use apps and quitlines. Smokefree.gov has a free text message program for pregnant women who are trying to quit. It also has a free app you can download to keep you on track. Call 1-800-QUIT-NOW for advice from a quit smoking counselor. Look for programs in your community or where you work that can help you stop smoking. These are called smoking cessation programs. Ask your provider about programs in your area. Ask your employer to see what services are covered by health insurance.
• Telling your family, friends and loved ones about your plan to quit smoking. They can help support you.

Other things to do to help you quit:

• Drink lots of water. Drink water or tea instead of coffee or alcohol.
• Try to manage your stress. Stress can be a trigger for smoking. Try things to relieve stress, like meditation, deep breathing, exercising or listening to your favorite music.
• Reward yourself for your progress. Celebrate milestones, like 1 day, 1 week and 1 month of being smoke-free.

If you have trouble quitting, keep trying! You’re doing what’s best for you and your baby.

More information

smokefree.gov (1-800-quit-now)

Centers for Disease Control and Prevention (CDC)

CDC tips for quitting smoking

Amanda’s story: Smoking during pregnancy and premature birth

Last reviewed: January 2019