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      Smoking during pregnancy

      Birthing Positions

      Smoking during pregnancy

      Read time: 3 minutes

      Smoking is a highly addictive habit that’s notoriously difficult to quit. However, like many parents-to-be, you may find that your pregnancy gives you the motivation you need to finally give up smoking once and for all.

      Learn more about the effects of smoking on your baby when you’re pregnant, advice about vaping during pregnancy, plus where to get support if you’re quitting smoking.


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      Effects of smoking in pregnancy on your baby

      The dangers of smoking during pregnancy are numerous, particularly in terms of the effect it can have on your baby. Risks to your baby include:

      • Increased risk of placental abruption – this is when your placenta partly or completely separates from the inner wall of your uterus before your baby is born1.
      • Increased risk of preterm birth1.
      • Increased risk of miscarriage or stillbirth1.
      • Increased rick of your baby having a low birthweight1.
      • Increased risk of Sudden Death Syndrome2.
      • Increased risk of behavioural problems in childhood3.
      • Increased risk of growth problems and obesity in adulthood4.
      • Increased risk of asthma in later life5.

      However, the good news is, stopping smoking in early pregnancy can almost entirely eradicate these risks6. That’s why stopping smoking is one of the best things you can do for your baby.



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      Cigarettes contain over 4,000 chemicals7. The majority of harmful effects of cigarette smoke primarily stem from carbon monoxide, tar and nicotine1. These chemicals enter your blood stream and are passed onto your baby via your placenta and umbilical cord, restricting the supply of oxygen to your growing baby8.

      Vaping in pregnancy

      The Royal College of Physicians approximates that there is 5% of the risk of normal cigarettes in e-cigarettes So whilst vaping is not completely risk free, it is far less harmful than regular smoking and may be a helpful way to begin your journey to quitting smoking9.  

      Passive smoking during pregnancy

      Even if you don’t smoke yourself, second-hand smoke can still have negative effects on you and your baby10. If you live with someone who smokes, and they’re unable to quit you should avoid being near them when they’re smoking.

      Carbon Monoxide (CO) breath testing

      One of the most toxic chemicals in cigarettes is carbon monoxide1. When you smoke, carbon monoxide replaces some of the oxygen going into your lungs and gets into your bloodstream, affecting your baby. If you, or someone you live with, smoke, a simple breath test will show how much carbon monoxide you and your baby have been exposed to, and therefore how much risk you’re at from smoking related illness. Your midwife will likely perform this test during your booking appointment and depending on your results, at subsequent appointments too11.

      Quitting smoking

      If you’re finding it hard to quit smoking, your GP may prescribe Nicotine Replacement Therapy (NRT) in the form of patches, chewing gum, sprays (nasal or mouth) or lozenges. These only contain nicotine (the addictive substance in cigarettes) and therefore removes the risk of other harmful chemicals in cigarettes such as tar and carbon monoxide12. It’s worth noting that patches should only be worn for a maximum of 16 hours in any 24-hour period13. A good way to remember this is to remove the patch at bedtime.

      It’s best to avoid liquorice-flavoured nicotine products, due to the negative effects associated with excessive amounts of liquorice root11.


      Services to help you quit

      If you’re serious about quitting, studies show you're three times more likely to stop successfully if you use a combination of nicotine replacement and specialist support14.

      1. McDonnell B, Regan C. Smoking in pregnancy: pathophysiology of harm and current evidence for monitoring and cessation. Obstet Gynaecol 2019;21(3) Available at: [Accessed May 2020]
      2. Shah T et al. Sudden infant death syndrome and reported maternal smoking during pregnancy. Am J Public Health. 2006;96(10):1757‐1759. Available at: [Accessed May 2020]
      3. Batstra L et al. Effect of antenatal exposure to maternal smoking on behavioural problems and academic achievement in childhood: prospective evidence from a Dutch birth cohort. Early Hum Dev. 2003;75(1-2):21-33. Available at: [Accessed May 2020]
      4. Maessen S.E. et al. Maternal smoking early in pregnancy is associated with increased risk of short stature and obesity in adult daughters. Sci Rep 2019;9(4290). Available at: [Accessed May 2020]
      5. Toppila-Salmi S et al. Maternal smoking during pregnancy affects adult onset of asthma in offspring: a follow up from birth to age 46 years. Eur Respir J. 2020;1901857. Available at: [Accessed May 2020]
      6. Suzuki K et al. Effect of maternal smoking cessation before and during early pregnancy on fetal and childhood growth. J Epidemiol. 2014;24(1):60‐66. Available at: [Accessed May 2020]
      7. NHS. Stopping smoking is the best thing you can do for your baby [Online]. Available at: [Accessed May 2020]
      8. Jokanović Lj et al. Possible influence of smoking on development and outcome of pregnancy. Gynaecol Perinatol. 1999;8(1):27–29
      9. Royal College of Physicians. Hiding in plain sight: Treating tobacco dependency in the NHS [Online]. 2018. Available at: [Accessed May 2020]
      10. Amasha H, Jaradeh S. Effect of active and passive smoking during pregnancy on its outcomes. Health Science Journal. Available at : [Accessed May 2020]
      11. NICE. Smoking: Stopping In Pregnancy And After Childbirth [Online]. 2020. Available at:  [Accessed May 2020]
      12. Hickson C et al. Comparison of nicotine exposure during pregnancy when smoking and abstinent with nicotine replacement therapy: systematic review and meta-analysis. Addiction. 2019;114(3):406‐424. Available at: [Accessed May 2020]
      13. NHS. Stop Smoking In Pregnancy [Online]. 2020. Available at: [Accessed May 2020]
      14. NHS Smokefree. Improve your chances of quitting successfully with stop smoking medicines [Online]. Available at [Accessed May 2020]

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