Myths: Smoking and Pregnancy
Counseling, financial incentives, and feedback-based interventions such as cognitive behavioral therapy are associated with a reduction in smoking during pregnancy and decreased risk for infants with low birth weight. Intervention context and strategies should be individualized 45 Nov 23, · Here are some tips to help you deal with quitting: Understand the threat - Smoking during pregnancy can cause health problems with both baby and mom. Smoking causes Taking your time - The gradual process of stopping smoking during pregnancy is not one that will be the most effective. Stop right.
So where does that leave expectant moms who were smokers before they got pregnant? Here's all the info you need on why smoking cigarettes is never safe during pregnancy, the smoing it can have pregnxnt you and baby, and steps you can take to quit so that neither of you is whil danger.
Happily, there's no clear evidence that any smoking you've done before pregnancy — even if it's been a habit cigxrettes 10 or more years — will harm the baby you're now busy making. Specifically, smoking around the time of conception increases the risk of ectopic pregnancyand continued smoking can up the chances of a wide variety of pregnancy complicationsincluding abnormal implantation or premature detachment of the placenta, premature rupture of the membranes, and early delivery.
In effect, when a mom lights up, her fetus exposed to a slew of toxic chemical. The most widespread risks for babies of smokers are low birthweight, shorter length at birth, and smaller head circumference, as well as cleft palate or cleft lip and heart defects. And being born too small is the major cause of newborn illness and death. The effects of tobacco use, like those of alcohol use, are dose-related: Tobacco reduces the birthweight of babies in direct proportion to the number of cigarettes smoked, with a pack-a-day smoker 30 percent more likely amoking give birth to a low-birthweight child than a nonsmoker.
But cutting down can be misleading, because a smoker often compensates by taking more frequent and deeper puffs and smoking more of each cigarette. This can also happen when a smoker switches to low-tar or low-nicotine cigarettes. In short, even the occasional cigarette whle too much smoke exposure for your fetus. Staying smoke-free is also critical after your baby is born. Potential risks for babies of sfop include:.
The good news is that if you xmoking smoking early in your pregnancy, you may be able to radically reduce the risk of harm to your baby.
In fact, a recent pregnznt found that women who what are you looking at lyrics smoking no later than prrgnant third month can eliminate all of the associated risks. The most important thing to do now is to get serious about your health and prenatal hw — and that includes quitting smoking.
So get some help nixing that nicotine fix. If you're like many smoking women, quitting will never be easier than in early pregnancy, when you may develop a sudden distaste for cigarettes — probably the warning of an intuitive whike. Otherwise, there is plenty of help for smokers who want to kick the habit. Among the strategies that have made quitters out of smokers are hypnosis, acupuncture and relaxation techniques. Or seek support online from other pregnant women who are trying to call it quits.
Check out smokefree. Ask prefnant practitioner. Despite little research on electronic cigarettes during pregnancymost experts how to hack the school grading system against puffing on those, either. E-cigarettes, which claim to have significantly fewer toxins and less nicotine than traditional cigarettes, still contain enough to potentially affect your baby. Additives and flavorings used in many e-cigarettes may also be questionable when you're growing a baby.
Ultimately, until more is known — and more regulation is in place — you're better off staying away from e-cigarettes. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff.
Continue Reading Below. Recommended Reading. View Sources. National Institutes of Health, Smokefree. American College of Obstetricians and Gynecologists, Tobacco. Alcohol, Drugs, and PregnancyJune September Your Health. Pregnancy Groups. Jump to Your Week of Pregnancy. Delivering at a Birth Center. Please whitelist our site to get all the best deals and offers whi,e our partners. What to How to care for cyclamen for Lunch During Pregnancy.
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Sep 29, · The best time to quit smoking is before you get pregnant, but quitting at any time during pregnancy can help your baby get a better start on life. Talk to your doctor about the best ways to quit while you’re pregnant or trying to get pregnant. When you stop smoking: 1. Your baby gets more oxygen, even after just 1 day. Your baby will grow better. Oct 14, · Happily, there's no clear evidence that any smoking you've done before pregnancy — even if it's been a habit spanning 10 or more years — will harm the baby you're now busy making. But research shows that smoking during pregnancy can have devastating consequences.
Read terms. ABSTRACT: Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function. Children born to women who smoke during pregnancy are at an increased risk of respiratory infections, asthma, infantile colic, bone fractures, and childhood obesity.
Smoking cessation at any point in gestation benefits the pregnant woman and her fetus. The greatest benefit is observed with cessation before 15 weeks of gestation. Although cigarettes are the most commonly used tobacco product in pregnancy, alternative forms of tobacco use, such as e-cigarettes or vaping products, hookahs, and cigars, are increasingly common.
Clinicians should advise cessation of tobacco products used in any form and provide motivational feedback. Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions.
Available cessation-aid services and resources, including digital resources, should be discussed and documented regularly at prenatal and postpartum follow-up visits. The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions: Obstetrician—gynecologists and other obstetric care professionals should inquire about all types of tobacco or nicotine use, including cigarette smoking, use of e-cigarettes or vaping products, hookahs, snus, lozenges, patches, and gum, during the prepregnancy, pregnancy, and postpartum periods.
Health care professionals should be aware that patients may not intuitively equate alternative forms of nicotine use ie, e-cigarettes and vaping products with tobacco use. Further, health care professionals should advise cessation of tobacco products used in any form and provide motivational feedback.
Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function.
Screening and intervention for alcohol and other drug use are recommended for all pregnant women. Because smoking continuation during pregnancy is associated with the likelihood of other substance use, screening for alcohol and other substance use is an important component of care.
Providing continual support and addressing psychosocial stressors in the postpartum period are necessary to ensure continued cessation success. Increased community education measures and public health campaigns in the United States have led to a decrease in smoking among pregnant women and women in the postpartum period 1. Although reported rates of tobacco smoking during pregnancy in the United States decreased from Women in certain demographic cohorts are more likely to smoke during pregnancy, including women aged 20—24 years Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes 5 6 , low birth weight, increased perinatal mortality 7 , ectopic pregnancy 7 , and decreased maternal thyroid function 7 8.
The risks of smoking during pregnancy extend beyond pregnancy-specific complications. Children born to women who smoke during pregnancy are at an increased risk of respiratory infections, asthma, infantile colic, bone fractures, and childhood obesity 12 13 14 15 Researchers also have reported that infants born to women who use smokeless tobacco during pregnancy have increased levels of nicotine exposure and rates of low birth weight, shortened gestational age, stillbirth, and neonatal apnea that are as high as those in infants born to women who smoked during pregnancy 5 17 18 Although cigarettes are the most commonly used tobacco product in pregnancy, alternative forms of tobacco use, such as e-cigarettes or vaping products, hookahs, and cigars, are increasingly common 4 Table 1.
Data regarding the health effects of these agents in humans are limited in the general population and in pregnant women specifically. Whereas there is an incorrect perception that vaping represents a safer alternative to cigarette smoking because users are not inhaling tobacco combustion products, these products often contain nicotine or nicotine salts. Even if nicotine is not present in the e-liquid, exposure to flavorants and combustion products from the heating mechanism occurs.
Nicotine crosses the placenta and intake in any form has considerable health risks with known adverse effects on fetal brain and lung tissue 20 21 Hookah water pipe tobacco smoking is more commonly used by adolescents and young adults because many perceive it to be a safer alternative to conventional cigarettes 23 24 However, users are exposed to nicotine and charcoal briquette combustion products, including carbon monoxide, particulates, oxidants, heavy metals, phenols, and flavorants, through inhaling tobacco smoke from heated coal Short-term effects may include increased heart rate, increased blood pressure, and impaired pulmonary function, whereas long-term use may increase risk of nicotine dependence, chronic bronchitis, emphysema, and coronary artery disease 23 Although studies of hookah use during pregnancy are lacking, animal data suggest an increased risk for low birth weight, neonatal death, and growth restriction Noncombustible products, such as snus, dissolvable tobacco, and electronic nicotine delivery systems ENDS ie, e-cigarettes or vaping products, e-hookahs, mods, and pods , have nicotine-related risks and an increased risk for oral cancer similar to that of chewing tobacco 27 28 29 30 Studies demonstrate an increased risk of altered fetal autonomic cardiac regulation and nicotine withdrawal in neonates born to women who used snus during pregnancy, effects that are similar to those found in women who smoke tobacco 32 Although more research is needed to quantify the perinatal effects with use of these products in pregnancy, the risks of noncombustible product use should be discussed.
Electronic nicotine delivery systems are noncombustible products, which include e-cigarettes and vaping products, vaporizers, hookah pens, vape pens, mod or pod systems, and e-pipes.
Health effects from heating liquid flavorants are unknown and likely vary depending on the combination of flavorants and solvents in the products inhaled 34 Carbonyl compounds formaldehyde, acetaldehyde, acetone, and acrolein ; volatile organic compounds benzene and toluene ; nitrosamines; particulate matter; and heavy metals such as copper, lead, zinc, and tin have been isolated from the aerosol Although much of the data on nicotine-delivery in pregnancy are derived primarily from animal studies, e-cigarettes appear to have similar effects on lung development and offspring lung health when compared with cigarette smoking Recently, the Centers for Disease Control and Prevention CDC issued an advisory notice investigating a multistate outbreak of noninfectious severe pulmonary disease associated with e-cigarette and vaping product use With the recent CDC advisory and the effects of e-cigarette and vaping product use on offspring health, immediate discontinuation of e-cigarette and vaping products should be advised among all pregnant and postpartum women.
Electronic nicotine delivery systems are used by smokers who commonly believe that they are a safer and healthier alternative to cigarettes that will aid their smoking cessation efforts 38 Standardization of e-liquid and heating mechanisms is needed to better describe and understand the health effects of these products on pregnant women, fetuses, and offspring and to understand their role, if any, in smoking cessation.
Obstetrician—gynecologists and other obstetric care professionals should inquire about all types of tobacco or nicotine use, including cigarette smoking, use of e-cigarettes or vaping products, hookahs, snus, lozenges, patches, and gum, during the prepregnancy, pregnancy, and postpartum periods. Clinicians should be aware that patients may not intuitively equate alternative forms of nicotine use ie, e-cigarettes and vaping products with tobacco use.
Tobacco cessation, avoidance of secondhand smoke exposure, and relapse prevention are key clinical intervention strategies. Inquiry into tobacco use and smoke exposure should be a routine part of the prenatal visit.
The U. Preventive Services Task Force recommends that clinicians ask all pregnant women about tobacco use, advise tobacco cessation at all gestational ages, and provide behavioral interventions for those who smoke Public Health Service recommends that clinicians offer effective tobacco cessation interventions to pregnant women who smoke at the initial prenatal visit and throughout the course of pregnancy Addiction to and dependence on cigarettes is physiologic and psychologic, and cessation techniques should include psychosocial interventions and pharmacologic therapy.
Two counseling techniques with positive effects on smoking and nicotine cessation in pregnant women include motivational interviewing and cognitive behavioral therapy. Specific aspects of cognitive behavioral therapy shown to benefit pregnant women include developing a sense of self-monitoring and control, learning to manage cravings, managing situations of stress and anxiety, promoting self-efficacy, and goal setting and action planning Counseling, financial incentives, and feedback-based interventions such as cognitive behavioral therapy are associated with a reduction in smoking during pregnancy and decreased risk for infants with low birth weight.
Intervention context and strategies should be individualized 45 With appropriate training, obstetrician—gynecologists, family physicians, other clinicians, or auxiliary health care professionals can perform these five steps with pregnant women who smoke Referral to a tobacco quit line may further benefit the patient. Quit lines offer information, direct support, and ongoing counseling that help women quit smoking and remain smoke free Many states offer facsimile referral access to their quit lines for prenatal health care professionals.
Health care professionals can call the national quit line to learn about the services offered within their states. Examples of effective smoking cessation interventions delivered by a health care professional are listed in Box 2. Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products These women often are heavily addicted to nicotine and have greater psychosocial challenges.
Available cessation-aid services and resources, including digital resources 49 , should be discussed and documented regularly at prenatal and postpartum follow-up visits There currently is insufficient evidence to determine the effect of mindfulness 51 , hypnosis 52 , or acupuncture 53 for smoking cessation The patient should choose the statement that best describes her tobacco or nicotine use status:. I have never used tobacco or nicotine or have minimal amounts of tobacco or nicotine in my lifetime for example, less than cigarettes in my lifetime.
I stopped using tobacco or nicotine before I found out I was pregnant, and I am not using tobacco or nicotine now. I stopped using tobacco or nicotine after I found out I was pregnant, and I am not using tobacco or nicotine now. I use some tobacco or nicotine now, but I have cut down on the amount of tobacco or nicotine I use since I found out I was pregnant.
If the patient stopped using tobacco or nicotine before or after she found out she was pregnant B or C , reinforce her decision to quit, congratulate her on success in quitting, and encourage her to stay tobacco and nicotine free throughout pregnancy and postpartum.
If the patient is still using tobacco or nicotine D or E , document tobacco and nicotine status in her medical record, and proceed to Advise, Assess, Assist, and Arrange. ADVISE the patient who uses tobacco or nicotine to stop by providing advice about quitting with information about the risks of continued tobacco and nicotine use to the woman, fetus, and newborn.
Quitting advice, assessment, and motivational assistance should be offered at subsequent prenatal care visits. ASSIST the patient who is interested in quitting by providing pregnancy-specific, self-help tobacco and nicotine cessation materials. Support the importance of having tobacco and nicotine-free space at home and seeking out a quitting buddy such as a former tobacco or nicotine user.
Encourage the patient to talk about the process of quitting. For current and former tobacco and nicotine users, use status should be monitored and recorded throughout pregnancy, providing opportunities to congratulate and support success, reinforce steps taken towards quitting, and encourage those still considering a cessation attempt.
Treating tobacco use and dependence: update. Clinical Practice Guideline. Rockville, MD: U. A randomized trial of a serialized self-help smoking cessation program for pregnant women in an HMO. Am J Public Health ;—7. Physician advice regarding tobacco or nicotine-related risks 2—3 minutes. Videotape with information on risks, barriers to cessation, and tips for quitting; counseling in one minute session; self-help manual; and follow-up letters.
Counseling in one minute session plus twice monthly telephone follow-up calls during pregnancy and monthly telephone calls after delivery. Because smoking continuation during pregnancy is associated with the likelihood of other substance use, screening for alcohol and other substance use is an important component of care The benefits of reduced smoking are difficult to quantify or verify during pregnancy.
Women should be reminded that quitting outright best affects the long-term health of herself, her offspring, and her family The greatest benefit is observed with cessation before 15 weeks of gestation 42 Although smoking of any duration during pregnancy is associated with an increased risk of fetal growth restriction, the risk is reduced the earlier in gestation that cessation occurs Still, smoking cessation at any point in gestation benefits the pregnant woman and her fetus.
Pregnant women exposed to family members or coworkers who smoke should be given advice on how to address these situations and avoid exposure. Therefore, providing continual support and addressing psychosocial stressors in the postpartum period are necessary to ensure continued cessation success. Factors associated with the highest risk for postpartum smoking recidivism include living with a partner or family member who smokes, not breastfeeding, intending to quit only during pregnancy, and exhibiting low confidence in remaining tobacco-free postpartum Encouraging close follow-up, promotion of postpartum health and overall well-being, review of tobacco use prevention strategies, recognition of psychosocial challenges, and identification of social support systems in the third trimester and postpartum are helpful in decreasing recidivism 59 Preventive Services Task Force has concluded that current evidence is insufficient to assess the balance of benefits and harms of nicotine replacement products or other pharmaceuticals for tobacco cessation during pregnancy Recent reviews have suggested nicotine replacement therapy is associated with increased rates of smoking cessation during pregnancy