What do we know about tobacco use and pregnancy?

Smoking during pregnancy
Women who quit smoking before or early in pregnancy significantly reduce the risk for several adverse outcomes.

• Compared with women who do not smoke—
  • Women who smoke prior to pregnancy are about twice as likely to experience a delay in conception and have approximately 30% higher odds of being infertile.
  • Women who smoke during pregnancy are about twice as likely to experience premature rupture of membranes, placental abruption, and placenta previa during pregnancy.
• Babies born to women who smoke during pregnancy—
  • Have about 30% higher odds of being born prematurely.
  • Are more likely to be born with low birth weight (less than 2500 grams or 5.5 pounds), increasing their risk for illness or death.
  • Weigh an average of 200 grams less than infants born to women who do not smoke.
  • Are 1.4 to 3.0 times more likely to die of Sudden Infant Death Syndrome (SIDS).

Prevalence of smoking during pregnancy

According to 2004 Pregnancy Risk Assessment and Monitoring System (PRAMS) data from 26 states—

• Approximately 13% of women reported smoking during the last three months of pregnancy.
• Younger, less educated, non-Hispanic, white women and American Indian women are more likely to smoke during pregnancy compared to their older, more educated, counterparts.
• Of women who smoked during the last three months of pregnancy, 52% reported smoking 5 or less cigarettes per day, 27% reported smoking 6 to 10 cigarettes per day, and 21% reported smoking 11 or more cigarettes per day.

Secondhand smoke

Exposure to secondhand smoke causes premature death and disease in children and adults who do not smoke.

• Between 1988 and 2002, cotinine levels, a biological indicator of tobacco smoke exposure, declined by approximately 70% among children and non-smoking adults. Despite this positive trend, in 2002 nearly half of all children and non-smoking adults still had detectable levels of cotinine.
• Pregnant women who are exposed to secondhand smoke have 20 percent higher odds of giving birth to a low birth weight baby than women who are not exposed to secondhand smoke during pregnancy.
• Children are at greater risk of being exposed to secondhand smoke than adults.
  • During the period 1999–-2002, almost 40 million children, aged 3–19 years, or about 58% of children in this age group, were exposed to secondhand smoke.
  •  Infants who are exposed to secondhand smoke are more likely to die of SIDS compared to children not exposed.
  • Children who are exposed to secondhand smoke are at increased risk for bronchitis, pneumonia, ear infections, more severe asthma, respiratory symptoms, and slowed lung growth.

Selected Resources:

Preventing Smoking During Pregnancy Fact Sheet
Smoking during pregnancy is the single most preventable cause of illness and death among mothers and infants. This fact sheet provides information on prevalence, secondhand smoke, effective strategies and future directions ..more

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Pregnant? Don't Smoke: Learn Why and How to Quit for Good
Quitting smoking can be hard, but it is one of the best ways a woman can protect herself and her baby's health. For free help, call 1-800-QUIT-NOW (1-800-784-8669).

Maternal and Child Health Smoking Attributable Mortality, Morbidity, and Economic Costs (MCH SAMMEC)
An online application to estimate annual smoking-attributable medical expenditures, deaths, and years of potential life lost for infants in the United States. Updated 2004 mortality and economic costs now available ...more