Women and Smoking

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How can smoking affect your baby’s health?

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, and it varies by age. Pregnant women aged 18 to 25 smoke at higher rates, with more than 20% smoking in the past month, compared to nearly 13% of women 26 or older.

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. 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 quit during the first 3 to 4 months of pregnancy are less likely to have low birth-weight babies than those who keep smoking. 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.

Many women are able to quit smoking during early pregnancy. But those 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 get treatment for depression, anxiety, or nicotine withdrawal with medicines because of concerns about the drugs hurting the fetus. Still, 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 best 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.


Last Medical Review: 02/07/2014
Last Revised: 02/07/2014