Smoking and pregnancy


The risk of causing permanent harm to my baby was the trigger that finally helped me kick a 15-year addiction to cigarettes. It was sheer relief when, taking a puff of a cigarette around my ninth week of pregnancy, I knew it would be my last.

Many women smokers don’t realise they are pregnant, at least for some weeks, and expose their developing babies to tobacco toxins at an important development stage.

According to science

Patrick Holford and Susannah Lawson, authors of “Optimum Nutrition Before During and After Pregnancy”, say that smoking in the first few weeks after conception affects the way cells replicate and interferes with protein synthesis.

This is believed to be why babies born to smokers are more likely to suffer malformations, in particular cleft palates, hare lips, deafness and squints. They point out that the risk of birth defects increases by two and a half times, even if the woman doesn’t smoke while her partner does. This is because the mutagenic compounds of tobacco damage the chromosomes of sperm.

Motivation to quit

There is strong incentive to quit during the early stages of pregnancy. If women stop by the fourth month of pregnancy, they can reduce some of the risks associated with smoking, such as delivering low birth weight babies. Conversely, the more women smoke during pregnancy, the greater the reduction in birth weight.

Birth weight is a key indicator of health in later life. Lower weights have greater correlations with heart disease, strokes, diabetes and overall susceptibility to illness. Higher weights are associated with intellectual development.


For me, the motivation was simple: if the health of my baby couldn’t convince me to quit, what would? Even then, it took a little time.

The first step to encouraging a pregnant woman to quit is to arm her with a detailed understanding of the risks associated with smoking, in a factual and non-judgmental manner.

The next is to help her (and possibly her partner) through a cessation programme, and to maintain this after birth to prevent a relapse.

The risks

Before pregnancy

Smoking damages the quality of women’s eggs, and thus lowers the number that can make a healthy baby. It also reduces sperm concentration by about 24 percent.

During pregnancy

Women who smoke have a 27 percent higher risk of miscarriage, and a greater risk of still birth. They are also more prone to complications such as bleeding, pre-term delivery, premature rupture of membranes and placental problems. Some women experience higher levels of nausea associated with smoking.

At birth

Babies born to smokers have lower average birth-weights (between 150 and 300 grams, although good maternal nutrition can reduce the differential). This is because nicotine and carbon monoxide from cigarettes depletes oxygen and reduces blood flow from the placenta to the womb, leading fewer nutrients to reach the baby.

After birth

Babies born to maternal smokers suffer twice the risk of sudden infant death syndrome. They are prone to complications such as respiratory infections, bladder and kidney problems, and disorders of the nervous system, senses, blood and skin. Some studies show a correlation between smoking during pregnancy and attention deficit disorder.

Tips on how to quit


  • You can follow a similar programme to non-pregnant smokers. The starting point is to select the date on which you will stop and, instead of deciding to try, simply decide to stop.
  • You may opt for the cold turkey approach, or you may prefer a gradual cut-back.
  • Plan what you will do when a craving comes. They tend to last just a short time, so something simple might work, such as visualising your baby growing strong as you inhale clean air.
  • Enlist the support of family, friends and colleagues. Ask them not to smoke around you.

Smoking other stuff

It’s not just tobacco that’s bad for babies. Although there is inconsistent data on the effects of marijuana, mostly because it is often used with other drugs such as alcohol or tobacco, marijuana usage in pregnancy is associated with hyperactivity and cognitive impairment in children.

Regular marijuana use in men is associated with reduced sperm count.

Women who are dependent on heavy narcotics such as tik and heroin need to seek help. Their babies are often born dependent themselves and suffer withdrawal symptoms such as irritability and vomiting. Other problems include premature birth, low birthweight, breathing problems and low blood sugar.

Best kick-the-habit tips from CANSA:

  • Decide on a date to quit smoking and do it
  • Throw away your smoker’s paraphernalia: ciggie packets, ashtrays, lighters
  • Drink lots of water - it will help flush the nicotine from your body
  • Become more active - exercise ie walk, jog
  • Change your routine. Avoid smokers and things that make you want to smoke for the first couple of days
  • Tell your family and friends that you are trying to quit so that they can offer you support
  • You may experience some dizziness, headaches or coughing once you have stopped smoking. This is normal and should improve after a day or two and disappear within 14 days
  • The first two to three days are the most difficult, after that it gets easier. Your cravings will reduce and eventually disappear.
  • If you are worried about gaining weight, eat at regular times during the day. Snack on fruit between meals. Take time for exercise. Not all ex-smokers gain weight.
  • Do not use a crisis or special occasion as an excuse for "just one" cigarette. One cigarette leads to another and another, and another.
  • Don’t be too hard on yourself if you can’t cope with going cold turkey. You’re addicted to a serious drug, and you might need to get professional help to quit the addiction for once and for all.

Call in the heavy artillery

There are numerous natural therapies recommended by practitioners. Some people have managed to quit using hypnotherapy, acupuncture and reflexology.


For more information on qualified hypnotherapy practitioners in your area, contact the South African Institute of Hypnotherapy at 0861 102 318 or visit

To find a registered homeopath, reflexologist or acupuncturist in your area, contact The Allied Health Professions Council of South Africa at

To find out where you can attend a "Smokenders" course in your city or town, log onto their website at

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