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Active Smoking and its effects on Pregnancy


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Over 7 million people die due to some form of tobacco consumption each year. And the consequence of the same isn’t limited to independent smoking. There are allied risks of maternal smoking, secondhand or passive smoking, etc., which lead to many pregnancy and fetal complications.

Even CDC reports that one in five babies born to mothers who have indulged in prenatal smoking is either underdeveloped and have a low birth weight or are born prematurely. Sudden Infant Death (SID) risk is also heightened in pregnancy cases involving maternal smoking.

The impacts of smoking during pregnancy aren’t just limited to the mother’s health but irrevocably affect the child too. This article will explore all the side effects of active smoking and its impacts on pregnancy and fetal development.

How is Smoking Harmful to the Mother’s Body?

If a pregnant woman is smoking while carrying their baby, it is safe to say that they are addicted to nicotine or the drug that’s present in tobacco. A single cigarette drag exposes a pregnant woman to 7000+ chemicals, out of which 250 are harmful to the standard physiological functions, and 69 contribute to various types of cancers.

Active smoking in pregnancy has equally alarming impacts on the mother’s body. It can lead to various health complications, including:

  • Cancer (lung, mouth, throat, etc.)
  • Heart disease
  • Lung disease
  • Addiction
  • Diabetes
  • Stroke
  • Gum disease
  • Eye problems

These are some of the most common concerns that are associated with smoking. Extending the habit of smoking while pregnant further raises complications for the pregnancy and the baby developing inside the mother. We will discuss more of that in the next sections.

How does Active Smoking Affect Pregnancy?

The effects of smoking during pregnancy are drastic and often fatal as well. There’s a reason why doctors strictly advise avoiding cigarettes and alcohol during pregnancy. It raises the risks of multiple pregnancy complications, sometimes leading to fetal death or miscarriage.

Some of the most common side effects of active smoking during pregnancy are:

Preterm labor

Pregnancy is generally considered full-term when the mother completes 37 weeks of gestation. Most women who indulge in active smoking during pregnancy are at risk of experiencing preterm labor. This means that they experience labor symptoms before the 37 weeks mark.

Most cases of preterm labor lead to premature birth, putting the health and safety of the fetus at risk. Babies born prematurely are often at risk of having underdeveloped organs, have a low birth rate, and might have to spend the first few weeks or months of their lives in NICU to support their life.

Ectopic pregnancy

Most mothers who actively smoke before or during their pregnancy are at risk of developing an ectopic pregnancy. It is a condition wherein the fertilized egg implants itself anywhere but inside the uterus where it is supposed to. The implantation could be outside the uterus, on the fallopian tube, etc.

A case of ectopic pregnancy doesn’t lead to a full-term birth. It generally results in pregnancy loss. Once diagnosed with an ectopic pregnancy, it is not safe for the mother to proceed with the pregnancy since it might put their life at risk.

Vaginal bleeding

One of the harmful effects of smoking during pregnancy is the heightened risk of vaginal bleeding. It happens quite often, especially due to the nicotine and other active drugs that are in cigarettes.

Too much blood loss during pregnancy can lead to complications like anemia, iron loss, etc., which can raise further issues in the pregnancy.

Placental complications

Placental complications like placenta abruption or placenta previa are heightened in pregnant women who smoke throughout their gestation.

Both or either of these conditions is serious complications and, if not treated on time, can lead to a miscarriage, early labor, or preterm birth of the fetus.

Remember that pregnancy complications due to smoking aren’t limited to active smoking DURING your gestation. Some of these complications might happen even if you are an avid smoker while trying to get pregnant.

How does Active Smoking Affect the Fetus?

When growing a baby inside you, they depend on you for their nutrition, oxygen, etc. All of these are transferred to the fetus from the mother via the organ called the placenta.

A cigarette contains chemicals and drugs like nicotine, tar, carbon monoxide, etc., all of which are passed down to the fetus via the placenta during the pregnancy. So, in one way or another, your smoking habit directly impacts the fetus that’s growing inside you.

There are multiple dangers of smoking while pregnant. Here, we will discuss how it impacts the developing fetus.

Premature birth

Most fetuses exposed to active smoking by the mother during the pregnancy are at risk of being born prematurely. Any day before 37 weeks of gestation is considered a preterm delivery. Babies born prematurely or preterm are at risk of having low birth weight, weight less than 5 pounds.

Birth defects

Babies who are exposed to active smoking throughout the developmental period inside the womb are at risk of developing various kinds of congenital defects. The most common ones include cleft lip, palate, heart complications, etc.

Miscarriage or stillbirth

Active smoking in the mother during pregnancy also leads to potential risks of miscarriage, wherein the fetus dies in the womb before 20 weeks of gestation. It can also lead to stillbirth (fetal death after 20 weeks of gestation).

Sudden Infant Death Syndrome (SIDS)

SIDS claims the lives of thousands of babies each year. It is an unexplained medical condition wherein the baby dies within 1 year after birth. Often termed crib death, it generally happens when the baby is asleep. Although there are no standard or concrete reasons why it happens, active smoking could play a part in its occurrence.

The effects of smoking on pregnancy are terrible and often irreversible. So, if you are trying to conceive a baby or are already pregnant, discuss your options for managing your addiction to smoking with your doctor.

Are E-Cigarettes Safe during Pregnancy?

Active smoking using e-cigarettes is equally harmful to the mother and the baby, if not more. Unlike a standard cigarette, which contains tobacco inside it, an e-cigarette contains nicotine in liquid form inside it.

And the irony is that it’s not just the nicotine you have to worry about in an e-cigarette. Sometimes, even the flavorings in them can be harmful to the fetus.

Is Staggered Smoking Okay during Pregnancy?

Suddenly cutting out smoking can be challenging if you are an active smoker (and someone who is addicted).

So, is it okay to smoke one or two mild cigarettes during pregnancy? The answer is no. Cutting down on smoking means you are still consuming harmful drugs like nicotine in smaller doses, which are passed down to the baby via the placenta.

Quitting while you are pregnant or trying to get pregnant is ideal. This is especially important if you want to carry your baby to term and ensure that they are healthy and in its best shape after the delivery.

How to Quit Smoking During Pregnancy?

Unless you are pregnant accidentally, we recommend that you plan things before you start trying. If you are an active smoker and you are trying to conceive a baby, the first thing you have to do is let go of that harmful habit.

It’s not a choice; it’s a necessity for the sake of you and your baby. A quitting plan isn’t a one-day work. You have to put in a lot of resilience throughout the process actively. You should try to get pregnant only when you are sure you will not reach out for another cigarette.

Some of the top tips to quit smoking during pregnancy are:

Identify your reasons for quitting

This is easy when you are trying to get pregnant. Quitting with an end goal in mind enables you to stay focused and work towards that goal. You will stay determined not to get side-tracked because you know why you are doing this in the first place. So, if you are trying to quit because you are trying to get pregnant or are already pregnant, set that as your goal.

Deal with the cravings

If you have smoked every day for the past 10 years, going cold turkey will hit you hard. You are more likely going to experience heightened cravings for a single drag of a cigarette. If you don’t want to ruin your progress, you can counterfeit those cravings by distracting yourself. You can walk, engage in a hobby of your choice, etc.

Introduce a quit day

If you don’t know what quit day is, let us explain. You have to choose a day where you will pick up every last reminder of your smoking habit and throw it out in the trash. It can include cigarettes, e-cigarettes, matches, lighters, ashtrays, etc. Pick everything and throw them out.

Avoid triggers

Smoking is often a stress response. You are more likely to crave a cigarette when stressed or anxious. It is common human nature. To quit smoking, you have to identify those triggers and work on reducing them as much as possible, especially when you are on your road to recovery.

Celebrate milestones

Even if you go one day without smoking during your quitting journey, celebrate that. There’s nothing wrong with celebrating every milestone you achieve during your quitting journey. It is a rewarding experience and keeps you motivated to stay on track.

Besides these, we’d recommend you discuss your options with your gynecologist. If you are considering trying to get pregnant, your doctor will be able to guide you better on the next steps. Sometimes, it’s better to plan and reap the fruits instead of indulging in an unplanned pregnancy that could lead to complications for the baby due to the impacts of smoking.


  • What are the five risks associated with smoking during pregnancy?

Smoking during pregnancy elevates the risks of preterm birth, low birth weight, miscarriage, stillbirth, birth defects, etc.

  • How does smoking affect pregnancy in the first trimester?

Smoking during the first trimester is associated with poor fetal growth and development risks, placental abruption, or miscarriage.

  • At what stage of pregnancy does smoking affect the baby the most?

The most adverse impacts of pregnant women smoking happen during the second and third trimesters or as close as you get to your due date.


Active smoking during pregnancy has many consequences, not just for the mother but even more for the developing fetus. If you plan to get pregnant, discuss your options with your doctor before trying smoking or other tobacco-related products. It’s better to weigh your options first than risk everyone’s life and well-being.

Srujana Mohanty
She is the Managing Editor of Cogito137, one of India’s leading student-run science communication magazines. She's been working in scientific and medical writing and editing since 2018, also associated with the quality assurance team of scientific journal editing. Majored in Chemistry with a minor in Biology at IISER Kolkata, Srujana loves doodling and watching series.


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