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, midwife or other health professionals if you smoke or if you’re struggling to give up . They won’t judge you, and will want to help you. 

Smoking makes it harder to get pregnant. It’s very dangerous in pregnancy and can seriously harm you and your baby. It can also harm other children and people who live with you.

Won’t 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 worse. People who smoke are also more likely to develop depression than 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.

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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. This means that your medication dose may need to be changed if you quit. 

How does smoking affect fertility?

Smoking reduces your fertility, so people who smoke tend to take longer to get pregnant than those who don’t.

On average, people who smoke also have lower sperm quality than people who don’t.

It can also affect the success rates of fertility treatment. People who smoke need almost twice the number of IVF (in vitro fertilisation) attempts to get pregnant as those who don’t smoke.

The good news is that stopping smoking is likely to improve your fertility. It will also help to protect your baby from the moment you conceive. 

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How does smoking affect pregnancy?

Smoking is incredibly harmful for babies in the womb. 

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 these problems.

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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. You can get pregnant very quickly after stopping contraception, so try to quit before this.

But stopping at any point really helps.

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 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.

Can I cut down instead of stopping altogether?

Giving up smoking completely will give you the best chance of a healthy pregnancy. This 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 to 4 cigarettes a day makes an ectopic pregnancy more likely. Every cigarette you smoke stops your baby getting oxygen and makes their heart beat faster. 

Find out more about the effects of smoking when you are pregnant.

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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. They’ll give you practical tips and help you deal with any concerns like weight gain or stress.

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

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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. However, they do not contain the other 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?

Experts still aren’t sure exactly how e-cigarettes (vapes) affect pregnancy. They're less likely to harm you and your baby than smoking but are not risk-free. They do not produce tar or carbon monoxide, which are two of the most harmful products of tobacco smoke. But they do still contain some of the other harmful chemicals found in cigarettes, just at lower levels. 

Counselling and nicotine replacement therapies are safer options for helping you to 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 cannot get e-cigarettes on prescription but you can buy them and get advice from specialist vape shops.

Read about e-cigarettes and pregnancy.

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Is second-hand smoking a problem?

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

Second-hand smoke during pregnancy can harm your baby. It increases the risk of having a baby with a low birth weight, and the risk of SIDS.

Smokers who get support from family and friends are more likely to stop. So if the people around you give up smoking, they’ll also help you to quit. 

Get your personalised NHS Quit Plan

Where can I get help to stop smoking?

Call the free National Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

You can also find your nearest NHS stop smoking services by visiting the relevant website:

England

Wales

Northern Ireland

Scotland

NHS Smokefree

They provide support and information on how to stop smoking. There are also success stories to inspire you and help you keep on track. 

See our top tips for quitting smoking, or try our Planning for Pregnancy tool for more ways to have a healthier pregnancy.
 

NICE (2023) Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline [NG209]. Available at: https://www.nice.org.uk/guidance/ng209 (Accessed 27 March 2024) (Page last reviewed 16/01/2023)

NICE (2017) Fertility problems: assessment and treatment. Clinical guideline [CG156]. Available at: https://www.nice.org.uk/guidance/cg156 (Accessed 27 March 2024) (Page last reviewed 06/09/2017)

NICE (2023) Pre-conception - advice and management. Available at: https://cks.nice.org.uk/topics/pre-conception-advice-management/ (Accessed 27 March 2024) (Page last reviewed 04/2023)

NHS (2024) Stopping smoking for your mental health. Available at: https://www.nhs.uk/live-well/quit-smoking/stopping-smoking-mental-health-benefits/ (Accessed 27 March 2024) (Page last reviewed 10/01/2024. Next review due 10/01/2027)

NHS (2023) Stop smoking in pregnancy. Available at: https://www.nhs.uk/pregnancy/keeping-well/stop-smoking/ (Accessed 27 March 2024) (Page last reviewed 10/01/2023. Next review due 10/01/2026)

HRB National Drugs Library (2017) Pharmacy guidance on smoking and mental disorder. Royal College of Psychiatrists, National Pharmacy Association and Royal Pharmaceutical Society. Available at: https://www.drugsandalcohol.ie/27195/ (Accessed 27 March 2024) (Page last reviewed 04/2017)

Practice Committee of the American Society for Reproductive Medicine & Practice Committee of the American Society for Reproductive Medicine (2018). 'Smoking and infertility: a committee opinion'. Fertility and sterility, 110(4), 611–618. https://doi.org/10.1016/j.fertnstert.2018.06.016

Gaskins, A. J., et al. (2018) ‘Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy’. Fertility and sterility, 110(7), 1328–1337. https://doi.org/10.1016/j.fertnstert.2018.08.022
 

Review dates
Reviewed: 28 March 2024
Next review: 28 March 2027

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