Smoking and pregnancy

How does smoking affect my fertility?

Quitting smoking increases fertility for both females and males.

Females who smoke may have:

• difficulty conceiving
• early onset of menopause
• many cancers, including ovarian cancer

Males who smoke may have:

• trouble getting and maintaining an erection
• lower sperm count
• damage to DNA in sperm, causing health problems in your baby

How can smoking affect my baby?

Smoking during pregnancy exposes your baby to harmful chemicals. Every time you smoke, your baby effectively smokes. Nicotine and other harmful chemicals pass through the placenta and into your baby’s body. Smoking also reduces blood flow to your baby.

Smoking while pregnant can result in a far higher risk of:

• miscarriage
• stillbirth
• ectopic pregnancy
• premature birth
• low birth weight
• birth defects, such as cleft lip and palate
• damage to your baby's heart and lungs

Exposure to smoking during pregnancy can increase your baby’s risk of developing many health conditions, even after birth. This includes a much higher risk of lung conditions, middle ear infections and dying from sudden infant death syndrome (SIDS).

Babies who are exposed to second-hand smoke are also more likely to have inflamed airways, allergies and infections.

Other conditions, such as childhood cancers, obesity and dental problems, are more common among children exposed to second-hand smoke. However, it is not yet clear that passive smoking causes these problems.

Can I still breastfeed if I smoke?

When you smoke, nicotine and other harmful chemicals are passed on to your baby through breast milk, so it’s important to try to quit. But even if you continue smoking, breastfeeding is still best for your baby.

If you do smoke while breastfeeding, it’s best to wait until after a feed to smoke. This will minimise your baby’s exposure to nicotine and other chemicals found in cigarettes.

I don’t smoke, but my partner does. Can passive smoking during pregnancy be harmful to my baby?

Passive smoking carries the same risks of harm to both you and your baby. Pregnancy may be a good time for your household to become smoke-free.

If your partner or other household members aren’t ready to quit, ask them to smoke outside the house or car. It’s illegal to smoke with kids in the car.

How can I cut down or quit smoking?

Totally quitting smoking is the best goal, but some people find it easier to start by cutting down.

There are many different quitting methods. Many people need to try a few different methods before they find one that works for them.

Every attempt to give up cigarettes is a step towards becoming an ex-smoker. Talking to your doctor is a good starting point, as is contacting Quitline.

Methods that work include:

• going cold turkey — simply stopping smoking works for many people
• gradually cutting down how much you smoke until you stop completely
• support services such as Quitline
• mobile apps, such as My QuitBuddy
• nicotine replacement therapies
• prescription medicines (not recommended if you are pregnant, but your partner can try this if they smoke and want to quit)

Discuss your plans with your family and friends so they can support you.

What medicines or products can help me quit smoking?

Medicines that help to manage withdrawal symptoms — such as Champix (varenicline) or Zyban (bupropion) — are not recommended if you are pregnant or breastfeeding, but they may be suitable for other members of your household.

Nicotine replacement therapies (NRT) can help. They are readily available from pharmacies and some supermarkets, and come in 2 categories:

• steady response products, such as nicotine patches
• quick response products, such as chewing gum, lozenges, tablets and inhalers

Using NRT products is safer than smoking, but they can still be harmful to your baby. It is important to discuss the risks and benefits with your doctor or pharmacist, and follow their advice.

If you are pregnant, it’s better to use NRT lozenges, mouth spray, gum or inhalators, which usually provide a lower daily dose of nicotine than the patch.

If you have nausea or vomiting, you may prefer the patch. You can use the daytime patch to help you quit, but you should remove it before going to bed. You should not use the 24-hour nicotine patch during pregnancy.

Can vapes be used to help quit smoking?

There is limited evidence that vapes (also called e-cigarettes) are effective in helping to give up smoking in the short- or long-term.

In Australia, the safety of vapes for anyone’s use has not been assessed by the Therapeutic Goods Administration (TGA, the Australian Government medicine regulator). Because of this, vapes are not first-line treatments to help quit smoking.

Vapes can contain nicotine and other harmful chemicals that have many known and unknown health risks.

Due to the ingredients in vapes, even non-nicotine vapes may be harmful to your baby.

To give up smoking or vaping, you should speak with your doctor first. They can advise on how to quit according to your circumstances.

Are low-tar or roll-your-own cigarettes safer than traditional cigarettes?

There’s no evidence that low-tar, roll-your-own or natural tobacco cigarettes are safer for you and your baby than regular cigarettes. It’s also not recommended to switch to cannabis (marijuana) or use a water pipe instead of smoking. These substances carry their own risks to you and your baby, including low birth weight and poorer physical health.