Smoking and planning a pregnancy

If you are a smoker and planning to have a baby, the best thing you can do is stop before trying to get pregnant.

Smoking and infertility

If you smoke, it is likely to take you longer to get pregnant than a non-smoker. Most couples who have regular, unprotected sex (every 2-3 days) will get pregnant within a year. But for smokers, the chance of getting pregnant are cut by almost half each month.

Quitting smoking improves the lining of the womb. If you give up smoking now, your chances of getting pregnant faster will increase.

If you have not become pregnant after 12 months of trying, this is described as infertility. Women who smoke are twice as likely to be infertile as non-smokers.

This is true for women trying to become pregnant for the first time and for women who have been pregnant before.

Smoking can also affect the success rates of fertility treatment, such as IVF (In vitro fertilisation).

Can I improve my chances of getting pregnant if I stop smoking?

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

Becoming a non-smoker will also help if you are going through fertility treatment, such as IVF.

Does it affect my chances of getting pregnant if my partner smokes?

Yes. There are several reasons why your partner should stop smoking too if they smoke.

Passive smoking

Second-hand smoke, also known as passive smoking, is likely to affect your chance of conceiving.Even if you don’t smoke, breathing in the smoke from your partner’s cigarettes can damage your ability to get pregnant.

Having support helps you quit

Smoking is very addictive and it can be very difficult to stop, even if you really want to. But if your partner continues smoking, you are less likely to quit. Smokers who get support from family and friends are more likely to stop.

Try and quit smoking together. There is lots of support available to help you.

Smoking, fertility and men

Smoking can cause fertility problems in men. It can:

  • reduce the quality of semen
  • cause the semen to have a lower sperm count
  • affect the sperm’s normal swimming patterns
  • cause male sexual impotence (the inability to get or maintain an erection).

Will stopping smoking improve my partner’s fertility?

Again, the good news is that stopping can reverse some of the damage done by smoking. Quitting can:

  • improve sperm count and quality
  • reduce the risk of impotence over time.

Read more about men and fertility.

When should I stop smoking?

It is ideal if you can stop smoking at least four months before getting pregnant but stopping at any point really helps.

Can I cut down instead of stopping altogether?

Even low levels of smoking can make getting pregnant more difficult and is harmful to your pregnancy. Smoking 1-5 cigarettes a day, for example is a risk factor for ectopic pregnancy. Smoking less cigarettes does nothing to bring down the 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.

If you stop smoking before becoming pregnant then all your risks will become as low as for women who have never smoked.

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

Stopping smoking is better for your health and your babies’ health. Most women quit before pregnancy. If you are trying for a baby, quitting smoking altogether is the best thing you can do.

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

Nicotine is very addictive and it is common to have strong cravings for cigarettes and withdrawal symptoms such as restlessness and irritability.

If you are really struggling to quit, you might consider 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.

NRT products include:

  • patches

nicotine chewing gum

  • tablets, strips or lozenges
  • inhalators
  • spray for your nose

Nicotine replacement therapy can be bought from pharmacies and some shops. It's also available on prescription from a doctor or NHS stop smoking service. (jump link to more support and information.

Can I use e-cigarettes to quit?

E-cigarettes have been around for several years now and many smokers find them helpful when they are trying to quit.

We know that e-cigarettes don’t burn tobacco, so they don’t produce most of the harmful poisons that cigarettes do. E-cigarettes don’t produce carbon monoxide either, which can cause serious harm to an unborn baby.

Research suggests that they are much safer than smoking tobacco. However, research is still being done on the safety of e-cigarettes and we can’t say for certain yet what impact they have on the body.

Before thinking about using e-cigarettes to help you stop smoking during pregnancy you should consider using an intensive support service, such as the NHS Stop Smoking Services, that offers advice and support. These services can also advise you on licensed stop smoking products to help your quit attempt.

But if you feel that your e-cigarette is helping you to stay smoke free during pregnancy, then you should continue to use it.

There has been very little research done about whether smoking e-cigarettes has any impact on fertility for men or women. You can read about e-cigarettes and pregnancy here.

Pregnancy and smoking

Smoking is the biggest cause of pregnancy problems and loss that you can change.

It increases the risk of:

Every day of pregnancy that is smoke-free helps your baby’s health and development. Stopping before you get pregnant can help avoid the risk completely.

I may already be pregnant. Am I too late to stop smoking?

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

Stopping smoking during pregnancy reduces the risk of your baby being ill in the first month of life.

This does not mean that smoking in the first trimester is safe. The earlier you stop smoking the healthier you and your baby will be.

How do I stop smoking?

If you're finding it difficult to quit smoking, it's really important to get help.

Local Stop Smoking Services are free and delivered by professionals who provide expert advice, support and encouragement to help you stop smoking.

There is also plenty support available online and by phone to help you stop smoking.

NHS Smokefree
This website offers advice, tips on how to stop smoking and information and support, along with a free Quit Kit and other resources. There are also success stories to boost your resolve and help you keep on track. As well as visiting the website you can call the free Smokefree helpline on 0300 123 1044.

Action on Smoking and Health (ASH)
ASH is a charity that works to raise awareness about tobacco use and campaigns for ways to eliminate the damage caused by smoking. You can find information about different aspects of smoking and quitting, along with links to more stop smoking websites.

SmokeFree Baby
SmokeFree Baby is a smartphone app to help you give up smoking completely or substantially reduce the number of cigarettes you smoke during pregnancy. It has been developed by a team of experts at University College London, and it is available free of charge on iOS and Android.

Are you ready to conceive? Use our tool to find out.

Sources

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

2. NHS Choices (accessed 01/02/2018) 10 Health benefits of stopping smoking, Page last reviewed: 16/01/2016 Next review due: 04/01/2019 https://www.nhs.uk/live-well/quit-smoking/

3. NICE (2013) Fertility problems: assessment and treatment. National Institute for Health and Care Excellence

4. Clinical Knowledge Summaries (2012) Smoking cessation https://cks.nice.org.uk/smoking-cessation

5. ASH (accessed 01/02/2018) Smoking and reproduction, Page last reviewed: Dec 2016 http://ash.org.uk/information-and-resources/fact-sheets/smoking-and-reproduction/

6. Sue Macdonald and Gail Johnson Mayes’ Midwifery (Edinburgh: Baillir̈e Tindall Elsevier, 2017), p 306

7. British Medical Association (accessed 01/02/2018) E-cigarettes, Page last updated: 27 February 2018 www.bma.org.uk/collective-voice/policy-and-research/public-and-population-health/tobacco/e-cigarettes

8. Clinical Knowledge Summaries (Aug 2017) Pre-conception advice and management https://cks.nice.org.uk/pre-conception-advice-and-management

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Last reviewed on June 5th, 2018. Next review date June 5th, 2021.

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