First of all, up to 5% of infant deaths could be prevented if pregnant women did not smoke.

More than 10% of women smoke throughout their pregnancies − some studies put the number at 15% or higher, although it varies by age. Pregnant teens (ages 15 to 17) smoke at the highest rate, with more than 20% smoking in the past month.

Smoking is linked to an increased risk of early delivery and infant death. Babies born to smokers have a slightly higher risk of heart defects, cleft lip or palate, and possibly other birth defects compared to babies born to non-smokers. Research also suggests that babies of mothers who smoke during and after pregnancy are 3 to 4 times more likely to die from sudden infant death syndrome (SIDS) than babies born to non-smoking mothers. The risk of SIDS is somewhat less for infants whose mothers stop smoking during pregnancy, even if they start smoking again after delivery. But infants of non-smoking mothers have the lowest risk of SIDS.

Of the women who are able to stop smoking during pregnancy, half are smoking again 6 months after the delivery.

Smoking during pregnancy causes low birth-weight in at least 1 in 5 infants. This is because smoking during pregnancy slows fetal growth, often causing babies to have health problems as a result of being born underweight. Women who stop smoking before they get pregnant reduce their risk of having a low birth weight baby to that of women who never smoked. Women who quit during the first 3 to 4 months of pregnancy are less likely to have low birth-weight babies than those who keep smoking.

Many women are able to quit smoking during early pregnancy. But women who have mood disorders, such as depression, often find it much harder to quit. Researchers have learned that between one-third and one-half of women who smoke during pregnancy have a mood disorder. It can be harder for pregnant women to find treatment for depression, anxiety, or nicotine withdrawal with medicines because of concerns about the drugs hurting the fetus. Counseling or mental health therapy may help some of these women. If the woman is unable to quit smoking with therapy, she might want to talk with her doctor about other things she can try.

After a baby is born, nicotine and other substances in tobacco smoke can also be passed on through breast milk. This can affect a baby right away. For instance, infants who were breastfed by mothers who smoked slept for a full half-hour less than when the mothers didn’t smoke (this was measured over 3½ hours right after breastfeeding). It’s better not to smoke while breastfeeding. But even when the mother smokes, breastfeeding is still thought to be healthier for the baby than bottle feeding. And women who can’t quit right away can do other things to reduce the baby’s exposure:

• Make the entire home smoke-free
• Smoke right after breast-feeding rather than before
• Cut back on smoking as much as possible

If you managed to quit smoking while you were pregnant, don’t pick up the habit again after your baby is born. When you find yourself tempted to start back, get help right away. And keep in mind that parents who smoke are more likely to have children who smoke. So if you stay tobacco-free your child stands a better chance of never starting.

Secondhand smoke can affect your children’s health

It’s estimated that about 1 out of every 4 children ages 3 to 11 in the United States lives with at least one smoker. Studies show that older children whose parents smoke get sick more often. They have bronchitis and pneumonia more often, and they cough and wheeze more. Secondhand smoke can also trigger an asthma attack, make asthma symptoms worse, and even cause new cases of asthma in kids who had not shown symptoms before. More than 40% of children who go to the emergency room for asthma live with smokers. A severe asthma attack can be deadly.

Children who live with parents who smoke also get more ear infections. This often causes fluid to build up in their ears and they may need surgery to have ear tubes placed for drainage.

Some of these problems might seem small, but they add up quickly: think of the expenses, doctor visits, medicines, lost school time, and often lost work time for the parent who must stay home with a sick child. And this doesn’t include the discomforts that the child goes through.

The Surgeon General’s report: Secondhand smoke kills people who don’t smoke, and makes others sick

Secondhand smoke, also known as environmental tobacco smoke (ETS), has also been shown to increase the risk of lung cancer. The 2006 Surgeon General’s report on secondhand smoke stated that:

• Many millions of Americans, both children and adults, are exposed to secondhand smoke in their homes and workplaces, even though a great deal of progress has been made in tobacco control.
• Secondhand smoke causes premature death and disease in children and adults who do not smoke.
• Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), respiratory infections, ear problems, and more severe asthma.
• When parents smoke, it causes breathing (respiratory) symptoms and slows lung growth in their children.
• Secondhand smoke harms the heart, blood vessels, and blood circulation right away. Over time it can cause heart disease, strokes, and heart attacks.
• The scientific evidence shows there’s no safe level of exposure to secondhand smoke. Any exposure is harmful.
• The only way to fully protect non-smokers from exposure to secondhand smoke indoors is to prevent all smoking in that indoor space or building. Even separating smokers from non-smokers, cleaning the air, and ventilating buildings cannot keep non-smokers from being exposed to secondhand smoke.