What happens when a pregnant woman smokes in pregnancy

Smoking in pregnancy is harmful to your baby. Quitting is one of the best things you can do to protect your baby’s health during pregnancy and after they are born.

This information is about smoking in pregnancy. If you are trying to get pregnant, stopping smoking can help improve your chances of getting pregnant. It will also dramatically reduce your risk of pregnancy complications.

Why is smoking in pregnancy unhealthy?

Every cigarette you smoke contains over 4,000 chemicals. Many of these can harm your unborn baby.  

Cigarettes can reduce the amount of oxygen and nutrients that pass through the placenta from you to your baby. This increases the risk of serious pregnancy complications.

Stopping smoking can be hard. But it is one of the best things you can do for a safe and healthy pregnancy. 

How can smoking affect my pregnancy?

Smoking in pregnancy increase the risk of:

Smoking also increases the risk of sudden infant death syndrome after your baby is born.

This can be difficult to read if you are a smoker and are finding it difficult to stop. But there is lots of support available to help you.

Stopping smoking will help you and your baby immediately. The earlier you stop smoking the healthier you and your baby will be. But it is never too late to stop. Every day that your baby can develop in the womb without being exposed to cigarette smoke will benefit their health.

Can I cut down instead of stopping altogether? 

Smoking less is better than not trying to quit at all. But there is no safe level of smoking in pregnancy. For example, smoking fewer cigarettes does not reduce the risk of premature birth or low birth-weight.

Low-tar or low nicotine cigarettes are just as harmful to you and your baby’s health.

Smoking and breast or chest feeding

Stopping smoking can improve the quality of your breast milk and you will produce more of it.

Smoking and your mental health 

Taking care of your mental wellbeing as well as your physical health during pregnancy is important.

Some people say that the stress of stopping smoking is worse for the baby than smoking. The research shows that this is not true. Stopping smoking can improve mood and help relieve stress, anxiety and depression

Find out more about positive ways to manage your mental health during pregnancy.

Talking to your midwife about smoking 

At your first antenatal appointment (the booking appointment), your midwife will ask lots of questions about your lifestyle, including whether you smoke or have recently quit. You'll also be asked whether anyone you live with smokes.  

It’s very important to tell them if you smoke. Your midwife will not judge you. Their role is to help you and your baby be as healthy as possible.

They know the best ways to help people stop and will be very keen to help in any way they can. Find out more about getting help to stop smoking.

Your midwife should do a carbon monoxide breath test at your booking appointment. This will measure the levels of carbon monoxide gas in your body. Carbon monoxide is one of the poisonous gasses found in cigarette smoke, including secondhand smoke.

Can I use e-cigarettes to quit?

Many smokers use e-cigarettes (also known as vapes or e-cigs) to help them stop smoking.  

There has not been much research into the safety of e-cigarettes in pregnancy. But we know that e-cigarettes do not produce tar or carbon monoxide, the 2 main toxins in cigarette smoke. Carbon monoxide is particularly harmful to developing babies.  

The vapour from an e-cigarette does contain some of the potentially harmful chemicals found in cigarette smoke, but at much lower levels.  

If you're pregnant, licensed NRT products such as patches and gum are the recommended option to help you stop smoking. But if you find using an e-cigarette helpful, it's likely to be safer for you and your baby than continuing to smoke.

Find out more about using e-cigarettes in pregnancy.

Is secondhand smoke harmful?

Yes. Secondhand smoke (also known as passive smoking) can also affect you and your baby before and after their birth.

It doesn’t matter how much people try to keep their smoke away from you. Smoke can linger in the air for 2 to 3 hours after someone finishes a cigarette, even with a window open. 

Anyone living in your house can access NHS stop smoking services.

Find out more about secondhand smoke.

Smoking after pregnancy

Breathing in other people’s cigarette smoke is especially harmful for babies and children because they have less well-developed airways, lungs and immune systems.

Smoking around your baby can increase the risk of:

As well as the risks of secondhand smoke, children who grow up in homes where parents smoke are around 3 times more likely to smoke than children living in non-smoking households.

Find out more about smoking after your baby is born.

10 steps to quit smoking  

Your stop-smoking plan needs to work for you. Here are 10 steps you can take to quit smoking.  

Set a date to quit smoking   

Choose a day when you're going to quit so that you can prepare.  

Try and make it sooner rather than later – every cigarette you smoke passes dangerous chemicals to your baby.  

The night before you quit, throw away your cigarettes and ashtrays to help you avoid the temptation of 'just one more'.  

Contact a stop smoking adviser 

People who get help are more likely to quit.  

You can phone your local stop smoking service to make an appointment with an adviser. NHS have more details on how to find your local stop smoking service.  

Depending on your local area, you may be able to have 1-to- 1 or group support. This might be available at a clinic, in your own home, or over the phone or internet.  

The National Smokefree helpline also offers free help, support and advice on stopping smoking and can give you details of local support services. Call 0300 123 1044  

Sign up for helpful resources  

Try the NHS Quit Smoking app, which lets you track your progress, see how much money you’re saving, and get daily support.

Talk to your midwife or doctor 

Tell your midwife or doctor about your stop smoking plan. They can support you throughout your pregnancy.  

Tell your family and friends 

Secondhand (passive smoking) can affect you and your baby before and after they are born. You may also find it more difficult to quit if people are smoking around you.  

Make sure everyone knows you're quitting and why. Ask them not to offer you cigarettes or smoke around you. They can also help by distracting you when you're struggling with cravings.  

Be ready with distractions  

It’s always good to have some ideas ready to distract yourself from wanting a cigarette. Even pausing to take a few deep breaths can help. You could:  

  • arrange to call a friend if you get a craving  
  • have sugar-free chewing gum ready  
  • have some some crafts, puzzles or a good book close by  
  • download a quit smoking app, many of them have built in games to distract you if you have a craving.  

Change your routine 

Because you're used to smoking at certain times, places and in certain situations, it's a good idea to change your routine as much as you can at first so you can avoid as many 'smoking moments' as possible. 

Remind yourself why you're quitting 

Stopping smoking is one of the best things you can do to give your baby a healthy start in life. 

Every cigarette you don't smoke is a positive step. Be kind to yourself and tell yourself you're doing a great job.  

You could even try writing yourself a positive message of encouragement and putting it somewhere you look every day, such as on your fridge.  

Find out how much money you're saving 

Smoking is expensive. When you quit, try putting the money you would have spent on cigarettes aside to spend on things for the baby, such as clothes or toys. The NHS Quit Smoking app has one.  

Celebrate being smoke-free

Make regular treats and celebrations part of your plan to quit smoking. For example, 1 week smoke-free, 2 weeks smoke-free and so on.  

These will give you something to look forward to and help you stick to your goal.  

 Put away some, or all, of the money you would have spent on cigarettes and do something special.  

NHS. Stop smoking in pregnancy. https://www.nhs.uk/pregnancy/keeping-well/stop-smoking/ (Page last reviewed: 10 January 2023 Next review due: 10 January 2026)

Royal College of Obstetricians & Gynaecologists. Smoking and pregnancy. https://www.rcog.org.uk/for-the-public/browse-our-patient-information/smoking-and-pregnancy-patient-information-leaflet

British Medical Association (2014) Smoking and reproductive life; The impact of smoking on sexual, reproductive and child health, page 14. https://www.rauchfrei-info.de/fileadmin/main/data/Dokumente/Smoking_ReproductiveLife.pdf

NHS. Using e-cigarettes to stop smoking. https://www.nhs.uk/live-well/quit-smoking/using-e-cigarettes-to-stop-smoking/ (Page last reviewed: 10 October 2022 Next review due: 10 October 2025)

NHS. Passive Smoking. https://www.nhs.uk/live-well/quit-smoking/passive-smoking-protect-your-family-and-friends/ (Page last reviewed: 5 May 2022 Next review due: 5 May 2025)

NHS. What are the health risks of smoking? https://www.nhs.uk/common-health-questions/lifestyle/what-are-the-health-risks-of-smoking/ (Page last reviewed: 16 September 2022 Next review due: 16 September 2025)

Action on Smoking and Health (ASH) Young people and tobacco. https://ash.org.uk/category/information-and-resources/young-people-tobacco-information-and-resources/

Review dates
Reviewed: 23 November 2023
Next review: 23 November 2026