Pregnant women

Cigarette smoking during pregnancy has been linked to stillbirths, spontaneous abortions, decreased fetal growth, prematurity, low birth weight, placental abruption, sudden infant death syndrome (SIDS), cleft palates and cleft lips, and childhood cancers.

Pregnant smokers are often very motivated to quit smoking, and should be offered extra support for quitting. Quitting at any point in the pregnancy is beneficial to both mother and baby.

Give pregnant patients clear, strong advice to quit smoking as soon as possible. Offer assistance to pregnant smokers at the first prenatal visit and throughout the course of pregnancy, if necessary.

Consider providing pharmacotherapy if the pregnant woman is otherwise unable to quit, and consider whether the likelihood of quitting, with its potential benefits, outweighs the risks of pharmacotherapy and potential continued smoking.

Emphasize the importance of staying smoke-free once the baby arrives, and explain that maternal smoking has been linked to SIDS, respiratory infections, asthma, and middle ear disease in children.