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Smoking and pregnancy

Smoking during pregnancy is considered to be the biggest contributing factor to the development of complications during a pregnancy². Cigarette smoke contains over 4,000 chemicals such as carbon monoxide, nicotine and cyanide. Tobacco causes long term damage to the lungs, brain and blood of an unborn child and can cause pregnancy emergencies in the mother, by reducing the amount of essential oxygen and nutrients an unborn baby needs for healthy physical and mental development¹,³.

The sections below provide information about the risks of smoking when pregnant for both women and their partners, as well as the benefits for quitting before, during and after pregnancy:

Smoking and pregnancy: Information for women
Second-hand smoke: Information for partners
Smoking and reproductive health
Smoking and Sudden Infant Death Syndrome (SIDS)
Second-hand smoke: Effects on children

Smoking and pregnancy: Information for women

Smoke-free pregnancy – The benefits

Quitting smoking during pregnancy is the single most effective means of protecting your baby and yourself from the development of serious complications during pregnancy.

By quitting smoking before or during pregnancy you are:

more likely to conceive naturally and without delay
less likely to bleed during pregnancy
less likely to suffer a miscarriage or ectopic pregnancy
less likely to deliver your baby prematurely

By quitting smoking before or during pregnancy your baby is:

less likely to die at or shortly after birth from Sudden Infant Death Syndrome (SIDS)
more likely to be born a healthy weight
likely to be more settled and feed better
more likely to be discharged home from hospital with you and need less care in hospital.

A baby exposed to tobacco smoke in-utero and through second-hand smoke as an infant is more likely to develop type 2 diabetes, heart disease, kidney disease and be obese as an adult. This risk is increased even if they are non-smokers throughout their lives.

What can I do?

The good news is that by stopping smoking you and your baby benefit straight away. It’s never too late to quit smoking and gain the health benefits to mothers and babies of all ages.

Think about quitting smoking, for yourself and for your baby. There is always a good time to stop smoking – before, during or after the baby is born, the earlier the better.

Ask your health professional for specialised advice to help pregnant women and their partners quit smoking, or call the Quitline on 13 7848.

Nicotine Replacement Therapy (NRT) is now considered precautionary for use in pregnancy and lactation. Pregnant and breastfeeding women should seek advice from their medical professional prior to commencing NRT.

British Medical Association, 2007. Breaking the cycle of children’s exposure to tobacco smoke. Science and Education Department, British Medical Association, BMA House, London.
Lumley J. Oliver S & Waters E; 2003; Interventions for promoting smoking cessation during pregnancy (Cochrane Review); The Cochrane Library, Issue 1. Oxford.
Winstanley M, Woodward S & Walker N; 1995; Tobacco in Australia, Facts and Issues. Second edition, Victorian Smoking and Health program; Victoria.

Second-hand smoke: Information for partners

Partners who smoke

We all know that it’s dangerous for a woman to smoke when she’s pregnant. But it’s also dangerous if a pregnant woman who doesn’t smoke, has a partner who does. She will be breathing in tobacco smoke. The chemicals from cigarettes are passed onto the baby via second-hand smoke and carry the same risks to the mother and baby as if it were the mother smoking.

By quitting smoking or not smoking near your pregnant partner your baby is:

less likely to die from SIDS or cot death
less likely to suffer middle ear infections or have permanent hearing impairment
less likely to develop breathing problems like asthma and pneumonia
likely to be more settled and feed better.

What can I do?

Think about quitting smoking, for yourself and for your baby. There is always a good time to stop smoking – before, during or after the baby is born, the earlier the better.

In the mean time:

make your home and car smoke-free zones
avoid smoking around your partner and other pregnant women and encourage your friends and family to do the same
avoid smoking around children.

After the birth, do not smoke near your baby. If your partner smokes, support and encourage her to quit smoking for herself and the baby.

Smoking and reproductive health

Smoking and female fertility

Smoking can cause problems for virtually all aspects of the reproductive system. Women who smoke are more likely to have difficulty conceiving, may not respond as well to treatment for infertility, experience earlier menopause and have an increased risk of cervical and vulval cancer¹,³.

Smoking is associated with an increased risk of infertility, for both women attempting to become pregnant for the first time and women who have previously been pregnant. Women who smoke also have a poorer response to in vitro fertilisation (IVF)⁴,⁵.

Smokers have an increased risk for ectopic pregnancy and miscarriage. Ectopic pregnancy occurs when the fertilised eggs implants and begins to grow outside the uterus. The embryo needs to be surgically removed and the damaged tube needs to be repaired or removed⁵.

For more information on the effects of smoking on female reproductive health, see http://www.quitnow.info.au/internet/quitnow/publishing.nsf/Content/femalereprod

American Council on Science and Health. Cigarettes: What the warning label doesn’t tell you. Second edition. New York, American Council on Science and Health, 2003.
Cancer Research UK, News and Resources, http://info.cancerresearchuk.org/cancerstats/types/vulva/riskfactors/. (printed 02/07/07).
Better Health Channel, Smoking – Effects on your body. (Printed 09/07/07).
U.S Department of Health and Human Services. Women and Smoking. U.S Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Diseases Prevention and Health Promotion, Smoking and Health, 2001.
British Medical Association. Smoking and reproductive life: The impact of smoking on sexual, reproductive and child health. Board of Science and Education & Tobacco Control Resource Centre, February 2004.

Smoking and male fertility

Research has shown that male smokers have lower sperm quality and count than non-smokers².

Smoking can also lead to male erectile dysfunction. Two of the main chemicals in cigarettes are nicotine and carbon monoxide, which narrow the arteries and reduce the blood flow through the body, affecting the blood flow to the penis¹.

By quitting smoking you:

reduce the risk of impotence and improve your sperm quality
are less likely to have delays in falling pregnant or infertility.

For more information on the effects of smoking on make reproductive health, see http://www.quitnow.info.au/internet/quitnow/publishing.nsf/Content/malereprod

McVary KT. Carrier S. Wessells H - Subcommittee on Smoking and Erectile Dysfunction socio-economic committee: Sexual Medicine Society of North America;2001; Smoking and Erectile Dysfunction: Evidence Based Analysis; Journal of Urology; 166(5); 1624-32.
West R, McEwen A, Bates C; 1999; Sex and Smoking. Comparisons between male and female smokers; London No Smoking day.

Smoking and Sudden Infant Death Syndrome (SIDS)

Smoking by the mother is considered to be one of the major risk factors for Sudden Infant Death Syndrome (SIDS or cot death).

It is not known exactly what causes a baby to die from SIDS but recent research has indicated that SIDS has been found to be at least twice as likely among infants of women who smoke during pregnancy than among infants of women who do not smoke during pregnancy¹.

The chemicals and nicotine in cigarettes result in a reduced blood flow through the blood vessels of the placenta. The decreased blood flow reduces the amount of oxygen the growing baby receives and it is thought that the long periods of reduced oxygen flow affects the normal development of the baby’s central nervous system, which controls a baby’s breathing².

Current studies link SIDS deaths with both exposure of tobacco smoke to the unborn baby as well as through passive smoking in infants². Small children have very sensitive lungs and breathe at a faster rate than adults and their exposure to the chemicals in cigarettes is much higher than in adults.

One of the best ways to reduce the likelihood of a SIDS death is to quit smoking during pregnancy and to ensure the home is a smoke-free zone when there are infants and children living there.

For advice and support with quitting smoking call 13 7848 or speak with your health professional.

Laws PJ, Grayson N and Sullivan EA 2006. Smoking and Pregnancy. AIHW cat. No. Per 33. Sydney: AIHW National Perinatal Statistics Unit
NSW Department of Health (Ed.) 2006. Background papers to the National clinical guidelines for the management of drug use during pregnancy, birth and the early development years of the newborn. NSW Department of Health, Sydney.

Second-hand smoke: Effects on children

Children are especially vulnerable to the effects of environmental tobacco smoke or second hand smoke. They breathe faster than adults do and therefore inhale more chemicals. Young children whose parents smoke are nearly twice more likely to be admitted to hospital with serious lower respiratory tract infections than children who are not exposed²,³.

What are the risks of second-hand smoke to children?

Asthma – a major cause of chronic illness in children. Second-hand smoke exacerbates symptoms of asthma and there is strong evidence that it causes the development of asthma¹.

Middle ear disease – exposure to tobacco smoke in childhood causes acute and chronic middle ear disease. Ear infections can cause temporary hearing impairment and in chronic cases of ear infections, hearing may be permanently damaged¹.

Poor lung development – the lungs complete their development during childhood. Second-hand smoke inhibits this development by raising inhaled carbon monoxide to unsafe levels. This aggravates allergies and increases the risk of respiratory illness³.

Respiratory illness – including bronchitis, croup, bronchiolitis and pneumonia, the most common causes of childhood morbidity worldwide, affecting a third of all infants in their first year of life¹.

Sudden Infant Death Syndrome (SIDS) – the risk of SIDS is doubled in children exposed to environmental tobacco smoke.

More likely to become smokers – children who live with smokers are more likely to start to smoking than those who live with non-smokers, putting them at high risk of immediate and long term health problems.

Significant behavioural problems – including Attention Deficit Hyperactivity Disorder, deficits in intellectual disability and anti-social behaviour².

British Medical Association, 2007. Breaking the cycle of children’s exposure to tobacco smoke. Science and Education Department, British Medical Association, BMA House, London. 23
NSW Department of Health (Ed.) 2006.Background papers to the National clinical guidelines for the management of drug use during pregnancy, birth and the early development years of the newborn. NSW Department of Health, Sydney.
28. Samet JM. Background Paper, Synthesis: 1999; The Health Effects of Tobacco Smoke Exposure on Children. Department of Epidemiology School of Hygiene and Public Health, John Hopkins University, Baltimore USA. For WHO International Consultation on Environmental Tobacco Smoke (ETS) and Child Health, Geneva, Switzerland.

Acknowledgement – Much of the information on Smoking and Pregnancy has been provided by Quit Tasmania.

For more information please visit http://www.quittas.org.au/

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