A: Smoking is all too prevalent in our society. Between 12 and 22% of women smoke during pregnancy…this means that as many as one in five pregnant women smoke!

It's common knowledge that smoking puts women at increased risk of cancer, pulmonary (lung) problems, cardiovascular disease, and osteoporosis (weakening of the bones). But did you know that smoking effects reproductive function as well?

Reproductive Effects of Smoking

• Women who smoke have an increased risk of infertility and take longer to become pregnant.
• Women who do become pregnant while smoking have higher rates of ectopic pregnancy (pregnancy not located in the uterus) and miscarriage.
• Women who smoke during pregnancy have higher rates of complications including placental abruption (the placenta separates too early), premature rupture of membranes (the bag of water breaks too soon), preterm delivery, and stillbirth.
• Babies born to mothers who smoke tend to be smaller (fetal growth retardation) and have lower birth weights compared to babies of mothers who don't smoke. The longer a mother smokes during her pregnancy, the greater the effect that smoking has on her baby's weight.

The problems from smoking don't stop at delivery. Babies of mothers who smoke have a higher risk for Sudden Infant Death Syndrome (SIDS). Infants and children exposed to cigarette smoke have higher rates of asthma, middle ear infections, and respiratory illness. And mothers who breastfeed their children and smoke produce less breast milk and expose their infants to harmful chemicals in tobacco through lactation.

The Surgeon General reports that if smoking in pregnancy were eliminated, we would see a remarkable 12% reduction in perinatal deaths, and a 10% reduction in infant deaths.

How to Quit Smoking
If you're pregnant and smoking, quitting can make a substantial difference in your health. If you quit smoking during your pregnancy you'll reduce all of the risks described above. However, quitting is difficult — even when you're highly motivated. Nicotine is addictive, and it takes a lot of hard work and determination to quit smoking. It's not uncommon to make several attempts at quitting before you succeed. However, millions of people have been successful at quitting smoking. The rewards to you and your family are well worth the effort.

Reasons to Quit:

• You'll improve your own health, reducing your chance of having a heart attack, stroke or cancer.
• Your child will have a healthier mother who is likely to live longer.
• You'll improve your chances of having a healthy baby and lower your risks during your pregnancy.
• You'll be improving the health of people you live with, especially if you live with children.
• You'll be modeling healthy behavior for your children.
• Over time, you'll notice your teeth and breath are cleaner, your hair and clothes will smell better, and you'll have less wrinkling of your skin.

Make the Decision to Quit
If you've decided to stop smoking or you're thinking about stopping, congratulations! Quitting smoking will improve your own health and could be the most important gift you ever give your child. In order to give yourself the greatest chances for success:

Get ready …

• You are more likely to succeed if you have the support of your friends and family.
• If a close friend, housemate, or your spouse smokes, encourage this person to quit smoking along with you. You'll both be more likely to succeed.
• Ask all your friends and family NOT to smoke around you, and to support you.
• Think about your triggers for smoking — special times or places when you're likely to smoke — and make a plan for how to avoid these situations.
• Think of different ways to handle stress — taking a bath, meditating, exercising, deep breathing — and plan to use these when stressful occasions arise.

Get set …

• Set a date to quit smoking.
• Remove all cigarettes and ashtrays from your home, car and work.
• Set up a smoke-free zone in your home and work. Don't let others smoke around you.
• Write down your list of reasons for quitting, and keep this with you.

Go!

• Go for a walk, ride a bicycle, go to a movie. Find new activities to replace smoking and distract you from the urge to smoke.
• Spend time in places where you're not allowed to smoke.
• Drink lots of liquids, but avoid caffeinated beverages like soda, coffee and tea.
• Reward yourself for your success. For example, you could purchase treats for yourself or your baby with the money you save on cigarettes.
• Find new things to do with your hands (work on a craft project, draw or doodle, knit a baby blanket) and mouth (chew sugarless gum, use a toothpick or straw, suck on a cinnamon stick).

Getting Help

Many women who quit smoking benefit from professional help. Group counseling with a facilitator increases the likelihood of successful quitting. Contact your local hospital or health center to find out about group smoking cessation programs in your area. In some cases, physicians may be willing to prescribe medication or nicotine patches for pregnant women with heavy addictions. Additionally, if you've tried quitting in the past without success, consider using hypnotherapy or acupuncture; both are safe during pregnancy.

Excellent resources for quitting smoking:

http://www.cdc.gov/tobacco/quit_smoking/

American Cancer Society
1599 Clifton Road, NE
Atlanta, GA 30329
(404) 320-3333
http://www.cancer.org/docroot/PED/content/PED_10_13X_
Quitting_Smoking.asp

American Lung Association
1740 Broadway, 14th Floor
New York, NY 10019
(212) 315-8700
http://www.lungusa.org/stop-smoking/

U.S. Department of Health and Human Services,
Office on Women's Health
http://www.4woman.gov