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Smoking and pregnancy

The choices you make when you’re pregnant affect your baby’s health as well as yours. Now you’re pregnant, there’s never been a better time to stop smoking. The earlier you stop smoking in your pregnancy, the better.

There’s no safe amount when it comes to smoking. Any amount damages your health and your baby’s. Cutting down or switching to low-tar cigarettes isn’t enough. The safest thing is to stop smoking completely.

Hidden risks

When you smoke, you breathe in a cocktail of dangerous chemicals, including a gas called carbon monoxide.

You can’t see or smell it, but it’s harmful to you and your baby because it affects how your body uses oxygen.

Carbon monoxide:

  • affects how your baby grows and develops.
  • makes health problems more likely during your pregnancy and when you give birth

Testing for carbon monoxide

You will have a carbon monoxide test at your first antenatal appointment.

You blow into a machine which measures the carbon monoxide in your body and you get the results straightaway.

If the result is 4 or more your midwife will ask you whether you smoke, or whether you live in a house where someone else smokes. It’s best to be honest, so your midwife can get you the right help.

Reasons to quit smoking

Smoking doesn’t make labour or birth any easier or less painful, and it won’t affect the size of your baby’s head. But smoking can slow down growth, which means your baby could have health problems.

By stopping smoking:

  • you reduce the risk of having a miscarriage or your baby being stillborn
  • you reduce the risk of sudden unexpected death in infancy (SUDI), previously known as cot death
  • your baby’s more likely to be born a healthy weight and full-term (at around 40 weeks) – babies born too early and underweight are more likely to have feeding and breathing problems
  • your baby’s less likely to be born with health problems like asthma or a cleft lip and/or palate
  • you’ll lower your risk of heart disease and cancer
  • you’ll save money – just a month of not smoking could save you around £200 to spend on you and your baby

It’s good for you and your baby to stop at any point – the benefits will start straight away.

Vapes (e-cigarettes)

Vapes are not risk free.

There’s no evidence yet on the effects of long-term use.

The risks to a fetus are unknown.

Vapes are almost certainly less harmful for you than tobacco smoking, but the main aim is to stop using any vapes or cigarettes.

More about vapes

Second-hand smoke

If you live with or spend lots of time with someone who smokes, you’ll be breathing in their smoke too. This is called second-hand smoke.

Second-hand smoke is harmful for you and your baby. The chemicals linger in the air and can still be in the room 5 hours later. Opening windows or smoking in another room or out of a window won’t help.

When your baby’s born and you bring them home, ask anyone who cares for them to smoke outside or stop.

Any car your baby’s in must also be smoke free. It’s illegal to smoke in a car when someone under 18 is inside.

Getting support

If you smoke, you’ll probably have thought about stopping at some time. You may even have tried to stop more than once. If you have then you’ll know how hard it is.

It can be hard to tell your midwife that you smoke. Some women feel:

  • embarrassed
  • guilty
  • under pressure to stop.

Others think they might be judged or worry about what people think. These are natural worries but talking to your midwife can help you get the right support. Your midwife won’t judge and just wants to help.

Getting help to stop smoking

Sometimes smoking can be a response to other problems in your life, including money worries or mental health problems. Getting help with other issues may make it easier to stop smoking.

Read more about the support to available to help with the cost of living

Read advice about dealing with low mood, anxiety, phobias and stress

Supporting your partner

Dads and partners can help mum to stop smoking or stay smoke-free by:

  • distract her when she wants to smoke
  • helping her to plan, manage and change some of the routines when she might want to smoke
  • being patient when she’s finding it tough

If you also smoke:

  • do it outside and away from your partner and your baby and keep your car smoke-free too
  • try to quit together and support each other so you’ll both be less tempted to smoke

Further information, other languages and alternative formats

Translations and alternative formats of this information are available from Public Health Scotland.

If you need a different language or format, please contact phs.otherformats@phs.scot.

Last updated:
14 December 2023

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