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Giving up smoking and mental health medication

Information about giving up smoking while on mental health medication

It’s great that you are looking for advice and thinking about quitting cigarettes. This is the first step to being smoke free! There’s lots of support available to help you give up smoking.

Don’t be afraid to tell your GP or other health professionals if you smoke or if you’re struggling to give up – they will want to help you.

Smoking makes it harder to get pregnant and is dangerous in pregnancy because the toxins in cigarettes pass through the placenta to your baby. It can also harm other children and people who live with you.

Will giving up smoking make mental health illness worse?

You may have heard that smoking is better in pregnancy because it keeps you calm. This is not true.

People with mental health problems are likely to feel much calmer and more positive, and have a better quality of life, after giving up smoking.

Smoking has been shown to make anxiety or depression worse. In fact, smokers have a much higher risk of anxiety and depression when compared with non-smokers.

It’s best to give up smoking before you get pregnant but giving up at any time will benefit you and your baby.

Get your personalised NHS Quit Plan

Smoking and mental health medication

If you take medicine for your mental illness, it’s important to speak to your GP and psychiatrist or perinatal mental health team before you give up smoking.

Smoking causes your body to process medicines more quickly so your medication dose may need to be changed if you quit.

How does smoking affect fertility?

Smoking reduces your fertility, so it can take you longer to get pregnant than a non-smoker. Smoking can also affect the success rates of fertility treatment. Women who smoke need almost twice the number of  IVF (In Vitro Fertilisation) attempts to get pregnant as women who don’t smoke.

The good news is that women who have stopped smoking don’t take any longer to get pregnant than women who have never smoked.

How does smoking affect pregnancy?

Smoking is the biggest cause of pregnancy problems and loss that you can do something about.

It increases the chances of:

Every day of pregnancy that is smoke-free helps your baby’s health and development. Stopping before you get pregnant makes it less likely that you’ll have any of the problems listed above.

Get your personalised NHS Quit Plan

When should I stop smoking?

It is ideal if you can stop smoking before you get pregnant. This reduces the likelihood of harm to your baby. But stopping at any point really helps. You can get pregnant very quickly after stopping contraception, so try to quit before this.

I’m already pregnant. Am I too late to stop smoking?

No. It’s never too late. Every extra day your baby develops in the womb without toxins from cigarette smoke will make a big difference to their health in pregnancy and beyond.

Stopping smoking during pregnancy reduces the risk of harm to your baby. The earlier you stop smoking the healthier you and your baby will be.

Get your personalised NHS Quit Plan

Can I cut down instead of stopping altogether?

Giving up smoking completely will give you the best chance of a healthy pregnancy and will reduce the likelihood of harm to your baby.

Even low levels of smoking can make getting pregnant more difficult and is harmful to your pregnancy. For example, smoking 1-5 cigarettes a day makes an ectopic pregnancy more likely. Smoking fewer cigarettes does nothing to bring down the risk of premature birth or low birth-weight.

How do I stop smoking?

If you're finding it difficult to quit smoking on your own, it's really important to get help. Your doctor or midwife can help and can refer you to an NHS Stop Smoking service.

Your doctor will work with you to put together your personal stop smoking plan. They may recommend counselling sessions and nicotine-replacement medicines. Individual or group support with an expert advisor can help you stop smoking by giving you practical tips and helping you think about how to overcome barriers to stopping.

Don’t use nicotine-free medicines, such as varenicline and bupropion, to help you stop smoking as they’re not safe to use during pregnancy or breastfeeding.

Get your personalised NHS Quit Plan

Can I use nicotine replacement therapy (NRT) to quit?

Yes. If you’re struggling to give up smoking, you might want to try nicotine replacement therapy (NRT).

Licensed NRT products ease the withdrawal symptoms by giving you small amounts of nicotine but without the harmful toxins and chemicals you get from smoking tobacco. You can use NRT during pregnancy. It’s available on prescription from a doctor or NHS stop smoking service. You can also buy NRT products from pharmacies and some shops.

NRT products include:

  • skin patches
  • nicotine chewing guM
  • tablets, strips or lozenges
  • inhalators
  • sprays for your nose or mouth.

Can I use e-cigarettes (vaping) to quit?

E-cigarettes (vapes) aren’t risk-free but they’re less likely to harm you and your baby than smoking.

The liquid and vapour in e-cigarettes contain some of the harmful chemicals found in cigarettes, but at lower levels. They don’t produce tar or carbon monoxide, which are two of the most harmful products of tobacco smoke.

Counselling and nicotine replacement therapies are safer options for helping you stop smoking. But if these haven’t worked for you, then vaping may be an option if it helps you stay smoke free.

If you are using or thinking about using e-cigarettes, contact your local NHS Stop Smoking Services for advice and support, or talk to your GP or midwife. You can’t get e-cigarettes on prescription but you can buy them and get advice from specialist vape shops.

You can read more about e-cigarettes and pregnancy here.

Does my partner smoking affect my fertility?

Even if you don’t smoke, breathing in the smoke from your partner’s cigarettes can lower your chances of getting pregnant. It can also reduce your chances of pregnancy after IVF.

Smoking may cause fertility problems in men, making it harder for you to get pregnant. Smoking can:

  • reduce the quality of semen
  • cause the semen to have a lower sperm count
  • affect the sperm’s normal swimming patterns
  • cause erectile dysfunction (problems getting or keeping an erection).

Quitting can improve sperm count and quality and reduce the risk of erectile dysfunction.

Smokers who get support from family and friends are more likely to stop. So by giving up smoking, your partner is also helping you to quit.

Get your personalised NHS Quit Plan

Where can I get help to stop smoking?

NHS stop smoking services in:

England

Wales

Northern Ireland

Scotland

NHS Smokefree
Support and information on how to stop smoking. There are also success stories to help you keep on track. As well as visiting the website you can call the free Smokefree helpline on 0300 123 1044.

[1] National Institute for Health and Care Excellence (2010) Smoking: stopping in pregnancy and after childbirth. Public health guideline [PH26]

[2] American Society for Reproductive Medicine (2018) Smoking and infertility: a committee opinion. Fertility and Sterility 110(4): 611-618.

[3] Marufu TC et al. (2015) Maternal smoking and the risk of still birth: systematic review and meta-analysis. BMC Public Health 15: 239.

[4] National Institute for Health and Care Excellence (2019) Clinical knowledge summary: Pre-conception - advice and management.

[5] Campion J, Hewitt J, Shiers D, Taylor D (2017) Pharmacy guidance on smoking and mental disorder – 2017 update. Royal College of Psychiatrists, National Pharmacy Association and Royal Pharmaceutical Society.

[6] Gilbody S et al. (2019) Smoking cessation for people with severe mental illness (SCIMITAR+): a pragmatic randomised controlled trial. Lancet Psychiatry 6: 379–90.

[7] National Institute for Health and Care Excellence (2019) Clinical knowledge summary: Pre-conception - advice and management.

[8] Campion J, Hewitt J, Shiers D, Taylor D (2017) Pharmacy guidance on smoking and mental disorder – 2017 update. Royal College of Psychiatrists, National Pharmacy Association and Royal Pharmaceutical Society.

[9] American Society for Reproductive Medicine (2018) Smoking and infertility: a committee opinion. Fertility and Sterility 110(4): 611-618.

[10] American Society for Reproductive Medicine (2018) Smoking and infertility: a committee opinion. Fertility and Sterility 110(4): 611-618.

[11] Collins GG, Rossi BV. (2015) The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertility Research and Practice 1(11).

[12] NHS England. Smokefree pregnancy referral pathway. www.england.nhs.uk/ltphimenu/prevention/smokefree-pregnancy-referral-pathway/

[13] National Institute for Health and Care Excellence (2019) Clinical knowledge summary: Pre-conception - advice and management.

[14] American Society for Reproductive Medicine (2018) Smoking and infertility: a committee opinion. Fertility and Sterility 110(4): 611-618.

[15] National Institute for Health and Care Excellence (2019) Clinical knowledge summary: Pre-conception - advice and management.

[16] National Institute for Health and Care Excellence (2019) Clinical knowledge summary: Pre-conception - advice and management.

[17] Abraham M et al (2017) A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PLoS ONE 12(2): e0170946.

[18] Gaskins AJ et al. (2018) Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 110(7): 1328–1337.

[19] Percival J (2012) Smoking cessation in pregnancy. Nursing in Practice. www.nursinginpractice.com/smoking-cessation-pregnancy

[20] National Institute for Health and Care Excellence (2010) Smoking: stopping in pregnancy and after childbirth. Public health guideline [PH26]

[21] National Institute for Health and Care Excellence (2013) Smoking: acute, maternity and mental health services. Public health guideline [PH48]

[22] Chamberlain C et al. (2017) Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database of Systematic Reviews. Issue 2. Art. No.: CD001055. DOI:10.1002/14651858.CD001055.pub5.

[23] National Institute for Health and Care Excellence (2010) Smoking: stopping in pregnancy and after childbirth. Public health guideline [PH26]

[24] McNeill A et al (2018) Evidence review of ecigarettes and heated tobacco products 2018. A report commissioned by Public Health England. London: Public Health England.

[25] National Institute for Health and Care Excellence (2019) Clinical knowledge summary: Pre-conception - advice and management.

[26] McNeill A et al. (2018). Evidence review of ecigarettes and heated tobacco products 2018. A report commissioned by Public Health England. London: Public Health England.

[27] Smoking in Pregnancy Challenge Group (2019) Use of electronic cigarettes before, during and after pregnancy: A guide for maternity and other healthcare professionals. http://smokefreeaction.org.uk/wp-content/uploads/2019/08/2019-Challenge-Group-ecigs-briefing-FINAL.pdf

[28] Smoking in Pregnancy Challenge Group (2019) Use of electronic cigarettes before, during and after pregnancy: A guide for maternity and other healthcare professionals. http://smokefreeaction.org.uk/wp-content/uploads/2019/08/2019-Challenge-Group-ecigs-briefing-FINAL.pdf

[29] Smoking in Pregnancy Challenge Group (2019) Use of electronic cigarettes before, during and after pregnancy: A guide for maternity and other healthcare professionals. http://smokefreeaction.org.uk/wp-content/uploads/2019/08/2019-Challenge-Group-ecigs-briefing-FINAL.pdf

[30] American Society for Reproductive Medicine (2018) Smoking and infertility: a committee opinion. Fertility and Sterility 110(4): 611-618.

[31] American Society for Reproductive Medicine (2018) Smoking and infertility: a committee opinion. Fertility and Sterility 110(4): 611-618.

[32] Collins GG, Rossi BV. (2015) The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertility Research and Practice 1(11).

[33] Biebel MG, Burnett AL, Sadeghi-Nejad H (2016) Male Sexual Function and Smoking. Sexual Medicine Reviews 4(4) 366-375.

[34] Collins GG, Rossi BV. (2015) The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertility Research and Practice 1(11).

[35] Biebel MG, Burnett AL, Sadeghi-Nejad H (2016) Male Sexual Function and Smoking. Sexual Medicine Reviews 4(4) 366-375.

[36] Yong LC et al (2014) Quit interest, quit attempt and recent cigarette smoking cessation in the US working population, 2010. Occup Environ Med. 71(6): 405-14.

Review dates
Reviewed: 01 July 2020
Next review: 01 July 2023

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