Smoking and vaping during pregnancy

Smoking cigarettes and vapes (e-cigarettes) can impact fertility for both females and males.

Females who smoke or vape may:

• have difficulty conceiving
• be at risk of early onset of menopause
• be at risk of many cancers, including ovarian cancer and cervical cancer
• have a lower supply of breast milk

Males who smoke or vape may have:

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

If you want a baby, you should try to quit smoking at least 3 months before you start trying to get pregnant. This is how long it usually takes for your body to make more sperm.

During pregnancy, there is no safe amount of smoking or vaping.

Smoking during pregnancy exposes your baby to nicotine and harmful chemicals. These substances pass from you, through the placenta, to your baby's body. Every time you smoke, your baby smokes.

Some vapes can contain up to 50mg/mL of nicotine. Vapes or e-cigarettes that contain nicotine are only available by prescription from a pharmacist. However, all vapes contain other chemicals that can harm you or your baby, like:

• acetone (found in nail polish)
• glycol (used in fog machines)
• formaldehyde (used in glues, and for preserving bodies)

Smoking or vaping while pregnant can result in a far higher risk of pregnancy complications, such as:

• miscarriage
• stillbirth
• ectopic pregnancy
• premature birth
• low birth weight
• birth differences, 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 higher risk of:

• lung conditions including inflamed airways and infections
• middle ear infections and hearing impairment
• dying from sudden infant death syndrome (SIDS)

Exposure to second-hand smoke may also place your child at risk of:

• allergies
• childhood cancers
• developmental issues
• obesity
• dental problems

The risks of vaping while pregnant are still being researched.

The harmful chemicals from smoking and vaping can also pass on to your baby through breast milk. So, it's important to try to quit.

If you can't quit smoking or vaping, you should still breastfeed. Try to exclusively breastfeed your baby for their first 6 months.

It's best to wait until after breastfeeding to smoke. This will reduce your baby's exposure to nicotine and other chemicals found in cigarettes.

Passive smoking or second-hand smoking puts both you and your baby at risk of harm. Pregnancy may be a good time for your household to become smoke-free and vape-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 in the car with kids.

The best way to protect yourself and your baby is to quit smoking and vaping.

There are many different ways to quit. You may need to try a few different methods before you find one that works for you. Every attempt to give up cigarettes is a step towards becoming an ex-smoker. You may try:

• going cold turkey — simply stopping smoking works for many people
• gradually cutting down how much you smoke until you stop completely

Both going cold turkey and cutting down on smoking can be easier if you:

• talk to your doctor
• engage with support services like Quitline
• avoid situations that might make you want to smoke or vape
• speak with your family and friends so they can support you

Having a good support network can also help you manage withdrawal symptoms.

Your doctor can also refer you for behavioural counselling, to help you quit smoking.

There are treatments available to help you quit smoking or vaping.

Nicotine replacement therapies

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

1. steady response products, such as nicotine patches
2. quick response products, such as chewing gum, lozenges, tablets and inhalers

NRT products are safer than smoking, but they can still be harmful to your baby. It's 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 products like:

• lozenges
• mouth spray
• gum
• inhalers

These usually provide a lower daily dose of nicotine than the patch. If you have side effects from these, such as nausea, 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.

Prescription medicines

There are some prescription medicines that can help manage withdrawal symptoms, such as:

• varenicline
• bupropion

These are not recommended if you are pregnant or breastfeeding. But they may be suitable for other members of your household.

Can vapes help me quit smoking?

There is limited evidence that vapes can help quit smoking in the short- or long-term.

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

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

There's no evidence that low-tar, roll-your-own or natural tobacco cigarettes are safer for you or 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 poor physical health.

For more information, you can visit:

• The Lung Foundation Australia website on quitting smoking.
• The Department of Health, Disability and Ageing website on helping someone to quit.

If you want to quit smoking, there are different resources available, such as:

• Quitline or Aboriginal Quitline — call 13 QUIT (13 7848) to speak with a counsellor or request a callback
• mobile apps, such as My QuitBuddy

There are also quitting resources specific to different states, such as:

• Australian Capital Territory — Get help to quit
• New South Wales — Icanquit
• Northern Territory — Smoking
• Queensland — Quit HQ
• South Australia — Be smoke free
• Tasmania — Quit Tasmania
• Victoria — Quit Victoria
• Western Australia — Make smoking history

Other languages

Do you speak a language other than English? These websites offer translated information:

• Health Translations — smoking
• Health Translations — vaping
• Multicultural Health Communication Service — quit smoking