Pregnancy and Smoking

Why is smoking harmful in pregnancy?

Tobacco smoke contains poisonous chemicals which pass into the baby's blood. Smoking when you are pregnant increases the risk of

• miscarriage.
• slowing the growth of the baby leading to a low birth weight.
• premature labour leading to the baby being premature ('prem').
• stillbirth.

Even after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, 'glue ear', and sudden infant death syndrome (cot death).

Of course, there are many other risks with smoking such as the increased risk of developing chest and heart disorders. See another leaflet called 'Smoking - The Facts' for details.

When should I stop smoking?

You and your baby will get most benefit, and the risks will be most reduced, if you stop before you become pregnant. Planning to become pregnant is a good incentive to stop smoking for many women who smoke, and is often a good time to persuade partners to give up too.

However, your baby will still gain some benefit if you stop at any point during pregnancy.

How can I stop smoking?

For many people it is not easy to stop. Below are some tips which may help.

• Write a list of all the reasons why you want to stop, and keep them with you. Refer to them when you are tempted to light up.
• Set a date for stopping, and stop completely. (Some people prefer the idea of cutting down gradually. However, research has shown that if you smoke less cigarettes than usual, you are likely to smoke more of each cigarette, and nicotine levels remain nearly the same. Therefore, it is usually best to stop once and for all from a set date.)
• Tell everyone. Friends and family often give support and may help you.
• Get rid of ashtrays, lighters, and all cigarettes.
• Be prepared for some withdrawal symptoms. When you stop smoking, you are likely to get symptoms which may include: nausea (feeling sick), headaches, anxiety, irritability, craving, and just feeling awful. These symptoms are caused by the lack of nicotine that your body has been used to. They tend to peak after 12-24 hours, and then gradually ease over 2-4 weeks.
• Be aware of situations in which you are most likely to want to smoke (for example, the pub). Try changing your routine for the first few weeks. If drinking tea and coffee are difficult times, try drinking mainly fruit juice and plenty of water.
• Take one day at a time. Mark off each successful day on a calendar. Look at it when you feel tempted to smoke, and tell yourself you don't want to start all over again.
• Be positive. You can tell people that you don't smoke. You will smell better. After a few weeks you should feel better, taste your food more, and cough less. You will have more money. Perhaps put away the money you would have spent on cigarettes for treats.
• Food. Some people worry about gaining weight when they give up smoking as the appetite may improve. Anticipate an increase in appetite, and try not to increase fatty or sugary foods as snacks. Try sugar-free gum and fruit instead.
• Don't despair if you fail and have a cigarette. You don't have to start smoking again. Pick yourself up and try again. Examine the reasons why you felt it was more difficult at that particular time. It will make you stronger next time.

What about medicines that can help you stop smoking?

Nicotine Replacement Therapy (NRT)
This can help if withdrawal symptoms are troublesome. Nicotine gum, sprays, patches, tablets, lozenges, and inhalers are available to buy, and on prescription. Using one of these roughly doubles your chance of stopping smoking if you really want to stop. A pharmacist, GP, or practice nurse can advise about NRT.

• If you are not yet pregnant, but are planning a pregnancy, an option is to try a course of NRT before becoming pregnant
• If you are pregnant, you should consider carefully with your doctor whether NRT is right for you. NRT is a medicine and may have effects on the baby. But, many people argue that NRT is safer than smoking as, unlike smoking, NRT just gives you nicotine. Smoking gives you nicotine plus a lot of toxic chemicals. So, if NRT does enable you to stop smoking, it may be worthwhile to take it even if you are pregnant.

Bupropion (trade name 'Zyban')
This may be useful before you become pregnant. It is a medicine which is used to help people to stop smoking. Taking bupropion roughly doubles your chance of stopping smoking if you really want to stop. It helps reduce the symptoms of nicotine withdrawal. But note:

• You should not take bupropion when you are pregnant as the risk to the unborn child is not known
• If you take bupropion, the course should be completed before your become pregnant.

What about counselling?

If you are committed to stopping smoking, but are finding it difficult, you may be helped by a counsellor who is trained to help people to stop smoking. There are a number of NHS Stop Smoking Services around the country which are staffed by trained counsellors. Ask your GP, practice nurse or midwife if counselling is available in your area.

Further help and information

NHS Pregnancy Smoking Helpline - Tel: 0800 169 9 169
This is a confidential support service. A specially trained person will answer your call who will listen to your needs, suggest different ways of giving up smoking and can send you a free information pack. Ask them to tell you about your nearest NHS Stop Smoking Service.

Giving up Smoking - www.givingupsmoking.co.uk
An online resource run by the NHS for all the advice, information and support you need to stop smoking and stay stopped. Includes a section about smoking in pregnancy.

Quit - A charity that helps people to stop smoking.
Quitline: 0800 00 22 00    Web: www.quit.org.uk

© EMIS and PIP 2006   Updated: June 2006   PRODIGY Validated