In the United States and Europe, cigarette smoking is the single largest preventable cause of stillbirth, birth defects (most commonly, low birth weight), premature delivery, and death of the newborn. In the United States alone, smoking was responsible for more than 40,000 infants with low birth weight in 1993.
Smoking exerts its ill effects on the fetus almost immediately. Fetal “breathing” movements, a sign of a healthy fetus, are reduced within 5 minutes after the pregnant mother lights up. Cigarette smoke contains a variety of toxins besides nicotine; some of the ones most harmful to the fetus are carbon monoxide and cyanide.
Only recently, researchers have discovered the ill effects that smoking during pregnancy can have on the child after birth. These include a higher risk of pneumonia and bronchitis and possibly a higher risk of attention deficit/hyperactivity disorder (ADHD) among children who were exposed in the womb to tobacco smoke. One recent study even suggests that certain neurological disorders in infants exposed to cocaine in the womb may be caused not by the cocaine exposure but rather by cigarette smoking by many cocaine-using mothers.
The good news is that many of these increased risks to the fetus and newborn are reduced or eliminated as soon as a pregnant woman quits smoking–the earlier in pregnancy the better. Experts agree that pregnant women should first try to quit smoking by using techniques that do not involve medications. These include education programs, one-on-one and group counseling, and behavior modification techniques. If your doctor or clinic can’t provide you with the help you need, call the American Lung Association (1-800-586-4872), the American Cancer Society (1-800-227-2345), or the American Heart Association (1-800-242-8721). These groups can help point you toward a local support group for people trying to quit smoking.
If nondrug treatments fail, you can discuss other treatments with your doctor. Nicotine patches may be part of a successful quitting strategy. Although they are not recommended for pregnant women, patches actually deliver less nicotine than a regular cigarette. Also, patches don’t seem to have as profound effects on the fetus as cigarette smoke does, perhaps because patches don’t contain the carbon monoxide and other poisons that are present in tobacco smoke. There is little evidence that bupropion (Zyban), another drug that helps people quit smoking, is safe for pregnant women, and this medication should not be prescribed to pregnant women except under exceptional circumstances.
Finally, having a nonsmoking partner greatly increases the chances that a pregnant smoker will be successful in her attempts to quit. Pregnancy (or plans for pregnancy) presents a great opportunity for both partners to quit smoking!