SummaryRead the full fact sheet
- Quitline counsellors have helped many pregnant women stop smoking. You can also talk with your doctor or maternity care team and make a quitting plan together.
- If you smoke while you are pregnant you are at increased risk of a wide range of problems, including miscarriage and premature labour.
- Babies whose mothers smoke during pregnancy are at higher risk of sudden unexpected death in infancy (SUDI), having weaker lungs and having an unhealthy low birth weight.
- Low birth weight babies are at greater risk of death and are more vulnerable to infection, breathing difficulties and long-term health problems in adulthood.
- Stopping smoking completely as early as possible during pregnancy best protects your health and the health of your baby.
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Smoking while pregnant exposes you and your unborn child to an increased risk of serious health problems. Passive smoking can also affect you and your unborn child. Australian studies showed that about 9 per cent of women smoked during pregnancy in 2019.
If you smoke while pregnant you are at increased risk of a wide range of problems including miscarriage and premature labour, You are twice as likely to give birth to a low birth weight baby compared to a mother who does not smoke. Low birth weight babies are at greater risk of death and are more vulnerable to infection, breathing difficulties and long-term health problems in adulthood.
The more cigarettes you smoke during your pregnancy, the greater your risk of complications and having a low birth weight baby. But cutting down the number of cigarettes you smoke does not reduce most of the risks to you and your baby. Stopping smoking completely early in your pregnancy best protects the health of you and your baby. But quitting at any time helps reduce harm.
Pregnancy complications from smoking
Some of the pregnancy complications more commonly experienced by women who smoke include:
- ectopic pregnancy – this is pregnancy outside the uterus, usually in the fallopian tube
- fetal death – death of the baby in the uterus (stillbirth)
- spontaneous abortion – known as miscarriage
- problems with the placenta, including early detachment from the uterine wall and blocking the cervical opening (placenta previa)
- premature rupture of the membranes
- premature labour.
Smoking during pregnancy – effects on your unborn baby
If you are pregnant, every time you smoke a cigarette, it reduces oxygen to your unborn baby and exposes them to many toxic chemicals.
Some of the many damaging effects of cigarette smoke on your unborn baby include:
- reduced oxygen supply and nutrients due to carbon monoxide and nicotine in tobacco smoke
- slower growth and development
- increased risk of birth defects such as cleft lip and cleft palate
- the baby’s movements are weaker in the womb for at least an hour after smoking each cigarette
- impaired development and working of the placenta
- harming the development of baby’s brain and lungs.
Smoking and breastfeeding
Breastfeeding has many benefits and helps to protect your child from chest and ear infections, and illnesses of the gut and lungs. Stopping smoking during breastfeeding is very worthwhile.
Some of the problems caused by smoking while breastfeeding include:
- Nicotine and some other chemicals in cigarette smoke can pass from you to your baby through your breastmilk.
- Smoking can reduce your milk production and the quality of your breast milk.
- Smoking while breastfeeding increases your baby’s risk of a range of health problems including colic and disrupted sleep patterns.
Women who smoke are less likely to breastfeed and are more likely to wean their children earlier than mothers who do not smoke.
If you are finding it hard to stop smoking:
- Try not to smoke before or during feeds. To give your body the longest time possible to get rid of nicotine from your breastmilk, breastfeed your baby first, then have your cigarette soon after. Do the same if you are using the nicotine lozenge, mouth spray, gum or inhalator to quit.
- Don’t smoke near your baby – go outdoors to smoke.
Smoking during pregnancy can cause problems for your child in later life
Smoking during pregnancy can impair your child’s health for years to come. Health effects may include:
- weaker lungs
- higher risk of asthma
- low birth weight, which is linked to heart disease, type 2 diabetes and high blood pressure in adulthood
- up to three times the risk of sudden unexpected death in infancy (SUDI).
- increased risk of being overweight and obese in childhood
- increased risk of attention deficit hyperactivity disorder (ADHD).
Pregnancy and stopping smoking
Talk to your maternity care team about how they can help you. You may make a quitting plan together.You can also call the Quitline (Tel. 13 7848). Quitline counsellors will provide free support during your pregnancy and for some time after to help you remain quit. Aboriginal Quitline counsellors are also available.
If you are finding it tough to stop smoking, don’t despair. It is never too late to stop smoking. Stopping smoking by the fourth month of pregnancy can reduce some of the risks, such as low birth weight and premature birth. Stopping smoking at any time allows oxygen to reach your baby more easily.
Nicotine replacement therapy during pregnancy
It is recommended that you first try to stop smoking without medication. However, if you are unable to quit, you may use nicotine replacement therapy (gum, lozenges, mouth spray, an inhalator, or 16-hour patches) to help you. While using these products is considered safer than smoking, even this smaller amount of nicotine may not be entirely risk-free for your baby.
If you are pregnant, it is important to talk with your doctor before using nicotine replacement therapy to discuss the risks and benefits of using it. The Quitline counsellors can also help you decide what support is best for you.
Where to get help
- Your GP (doctor)
- Your obstetrician
- Quitline Tel. 13 7848 (13 QUIT)
- Chamberlain C, O'Mara-Eves A, Porter J, Coleman T, Perlen SM, Thomas J, et al. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.:CD001055. DOI: 10.1002/14651858.CD001055.pub5.
- Greenhalgh, EM, Ford, C, & Winstanley, MH. 3.7 Pregnancy and smoking. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021.
- Greenhalgh, EM, Ford, C, & Winstanley, MH. 3.8 Child health and maternal smoking before and after birth. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021.
- Napierala M, Mazela J, Merritt TA, Florek E. Tobacco smoking and breastfeeding: Effect on the lactation process, breast milk composition and infant development. A critical review. Environmental Research 2016;151:321-338.
- Coleman T, Chamberlain C, Davey MA et al. 2015 ‘Pharmacological interventions for promoting smoking cessation during pregnancy’, Cochrane Database of Systematic Reviews, vol. 12, CD010078.
- Australian Institute of Health and Welfare. Australia's mothers and babies 2020 - in brief. Cat. no: PER 101. Canberra: AIHW; 2021.
- How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General, 2010, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, USA.
- The health consequences of smoking – 50 years of progress: a report of the Surgeon General, 2014, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
- Kharkova OA, Grjibovski AM, Krettek A, Nieboer E, Odland JO. Effect of Smoking Behavior before and during Pregnancy on Selected Birth Outcomes among Singleton Full-Term Pregnancy: A Murmansk County Birth Registry Study. International Journal of Environmental Research and Public Health 2017;14(8).
- Liu B, Xu G, Sun Y, Qiu X, Ryckman KK, Yu Y, et al. Maternal cigarette smoking before and during pregnancy and the risk of preterm birth: A dose-response analysis of 25 million mother-infant pairs. PLoS Med 2020;17(8):e1003158.
- Royal Australian College of General Practitioners. Supporting smoking cessation: a guide for health professionals. 2nd ed. East Melbourne, Victoria: Royal Australian College of General Practitioners; 2019.
- Bar-Zeev Y, Lim LL, Bonevski B, Gruppetta M, Gould GS. Nicotine replacement therapy for smoking cessation during pregnancy. Medical Journal of Australia 2018;208(1):46-51.
- Avsar TS, McLeod H, Jackson L. Health outcomes of smoking during pregnancy and the postpartum period: an umbrella review. BMC Pregnancy Childbirth 2021;21(1):254.