Pregnancy and smoking
Pregnancy and smoking is a critical public health issue, as smoking during pregnancy poses significant risks to both the expecting mother and the developing fetus. When a pregnant woman smokes, harmful chemicals from tobacco can cross the placenta, potentially impairing the fetus's development and leading to complications such as low birth weight, premature birth, and an increased risk of stillbirth. Research indicates that smoking can cause long-term health issues in children, including intellectual disabilities and respiratory problems.
Notably, the prevalence of smoking among pregnant women has declined significantly since the 1980s, from 36% to around 4.5% between 2016 and 2021, reflecting growing awareness and public health efforts. Quitting smoking at any point during pregnancy can greatly benefit both the mother's and baby's health, with positive changes occurring quickly after cessation. Furthermore, exposure to secondhand smoke during and after pregnancy is also harmful, contributing to complications similar to those faced by mothers who smoke.
Strategies for quitting include support groups and mobile apps, though some cessation products may not be safe during pregnancy. Overall, addressing smoking in pregnancy is vital for improving maternal and infant health outcomes.
Subject Terms
Pregnancy and smoking
DEFINITION: During pregnancy, a few simple cells will grow to form the baby. Organs such as the heart, lungs, and brain go through intense periods of development, and it is important to have the right building blocks to support this growth. Nutrients and oxygen that support a growing fetus are passed from mother to fetus through an organ called the placenta. Dangerous substances such as drugs, alcohol, and chemicals from recreational smoking can also pass through the placenta to the baby. Chemicals from smoke are absorbed into the blood from the mother’s lungs; many chemicals are toxic and interfere with the delivery of oxygen and nutrients to the baby. These chemicals can cause serious and chronic illnesses in adults and children. In a developing baby, the chemicals can also impair development—some health issues may be seen at birth, while others can develop later in a baby’s life.
Risks for Mother and Baby
Researchers do not yet fully understand how every chemical in tobacco smoke affects a growing baby, but they do know that the health risks are high. If an expecting mother smokes, she is more likely to have pregnancy complications that put both herself and the baby at risk. Such complications may be pelvic pain; early rupture of the membranes; placental problems (detachment, tearing, or slipping); stillbirth; premature births; and miscarriages. The percentage of women who smoke during pregnancy began decreasing significantly in the 1980s. Up to 36 percent of pregnant women in the 1980s smoked cigarettes, compared to around 18 percent in 1990, 12 percent in 2000, and 7 percent in 2015. From 2016 to 2021, cigarette use during pregnancy declined by about one-third for all race and age groups, from 7 percent to 4.5 percent.
Smoking while pregnant also puts the baby at a higher risk for serious complications, such as being born underweight, which is a sign that the baby has not adequately developed. One in every five babies of mothers who smoke while pregnant is born underweight, or less than 5 pounds, 8 ounces (2,500 grams). Smoking also increases the chances of early delivery or giving birth before thirty-seven weeks of gestation. This puts the baby at high risk for serious health issues, including intellectual disability, cerebral palsy, heart formation abnormalities, and lung problems. Babies are also at a greater risk for sudden infant death syndrome (SIDS) and developing attention deficit and hyperactivity disorders, cleft lip, or cleft palate.
It is also important to note that because the baby is exposed to nicotine through the placenta, smoking while pregnant can cause the baby to have nicotine withdrawal symptoms after birth. This can make the baby more jittery, nervous, and harder to soothe. The earlier an expectant mother stops smoking, the better it is for the baby and for the mother’s own health. Even shortly after stopping, an expectant mother will begin to recover. For example, within minutes, heart rate and blood pressure will drop. Within twelve hours, carbon monoxide levels in the blood return to normal (carbon monoxide decreases the level of oxygen in the body). Within just a couple of weeks, circulation and lungs improve their function.
In addition, women who smoke while they breastfeed continue to pass chemicals like nicotine to the baby through breast milk. Babies are also very susceptible to secondhand smoke. Women and their fetuses who are exposed to secondhand smoke during pregnancy are at an increased risk of complications similar to those of women who smoke while pregnant. Additionally, infants exposed to secondhand smoke after birth are at a greater risk for Sudden Infant Death Syndrome (SIDS), contributing to up to 30 percent of SIDS cases in the US each year. The chemicals in cigarette smoke interfere with brain activity and negatively impact infant breathing.
Quitting Smoking
After an individual quits smoking, the body goes through withdrawal. The individual may experience symptoms such as dizziness, depression, headaches, tiredness, irritability, and sleep problems. Withdrawal effects, however, are temporary, and cravings can be overcome by simple distraction techniques. Some distraction techniques are participation in such activities as walking; relaxation methods, such as deep breathing; drinking water; nibbling on healthy snacks, such as vegetables and fruits; sucking on a hard piece of candy; investing time into a hobby; and simply talking with others who have successfully quit smoking. It is a common misconception that switching to smokeless tobacco products is a healthier option during pregnancy and an alternative to quitting smoking, but this is a myth. E-cigarettes, vaping, and all forms of tobacco and smoking products are harmful during pregnancy.
In addition, specific programs and smoking cessation tools, also called nicotine replacement therapy (NRT), can help to decrease nicotine levels gradually. However, certain smoking cessation products, such as nicotine gum or patches, may not be safe to use while pregnant. Many programs and support groups exist that may be useful, including SmokefreeMOM, a text messaging program, and quitSTART, a mobile app.
Bibliography
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