Smoking or vaping in pregnancy and early life

Effects while trying to fall pregnant

Smoking can affect you and your partner's fertility if you're trying to get pregnant. This means it is harder to fall pregnant and can make fertility treatments less effective and in vitro fertilisation (IVF) less successful.

Smoking affects each stage of the reproductive process. Toxins in smoke can harm both sperm and eggs and can damage the DNA held within them. Smoking, vaping or breathing in second-hand smoke can mean it takes longer to get pregnant, affecting your fertility and creating a higher risk of not getting pregnant, despite trying.

If you quit, the benefits will begin immediately. As soon as you or your partner stop smoking, your fertility will start to improve.

Effects when pregnant

Nicotine is the product that makes tobacco cigarettes and vapes/e-cigarettes addictive. Inhaling nicotine can damage a baby's developing brain, lungs and other organs.

With every tobacco cigarette, some of the oxygen in your bloodstream is replaced with carbon monoxide, reducing the oxygen your baby receives. It can also affect how the placenta forms causing the nutrients your baby receives to be reduced. And all those harmful chemicals that you breathe in when you smoke or vape are absorbed into your bloodstream, which is then shared with your baby.

Smoking or vaping during pregnancy can create risks for you, your pregnancy and your baby.

Risks for your pregnancy include:

• miscarriage
• complications, such as ectopic pregnancy
• problems with the placenta and pre-eclampsia
• complications during birth.

Risks for your baby include:

• be born too early and not fully developed, or be born underweight and at higher risk of delayed development or disease
• have birth defects such as a cleft lip or cleft palate
• die from sudden infant death syndrome (SIDS)
• have feeding problems, and be harder to settle
• have middle ear infections or permanent hearing impairment
• suffer long-term damage to the lungs, brain and blood, leading to complications such as asthma or pneumonia
• have a weaker immune system
• become overweight or obese in childhood.

Effects after your baby is born

You may be tempted to start smoking or vaping again after your baby is born, even though you quit successfully during pregnancy. If you're breastfeeding, you may experience a decrease in your milk supply. You could also risk exposing your baby to nicotine through your breast milk, potentially affecting your baby’s development.

You or your partner’s smoking or vaping could affect the health of your child. Children breathe faster than adults, which means they inhale more chemicals when they are exposed to second-hand smoke.

Exposure to second-hand cigarette smoke or vape aerosol

Even if you don’t smoke or vape, breathing in second-hand smoke or vape aerosol means you and your baby could have the same level of risk as if you were a smoker. Tobacco cigarettes and vape products contain several known carcinogens, including:

• lead
• formaldehyde
• toluene.

Getting support to help you quit

Professional support

• Your GP and midwife should be able to provide you with information and advice, whether you’re ready to quit or not sure.
• Quitline has a free, specialised support program for women and their partners before, during and after pregnancy. Call 13 78 48 or request a call for more information.
• Sign up for the My Quit Journey program to receive emails with personalised support tips, motivational stories, professional health advice and much more as part of a 12-week program.

Your support network

• Setting up your support network can make your quit smoking during pregnancy journey easier. Involve your friends and family so you can talk to them when needed. You can also ask them to be patient with you as you deal with withdrawal symptoms. Ask your family and friends, not to smoke or vape around you.

Using nicotine replacement therapy (NRT)

Using NRT to help you quit is much safer than continuing to smoke. NRT is a short-term treatment that helps reduce withdrawal symptoms and cravings.

Research shows that nicotine metabolises faster during pregnancy, especially around the 18-week gestation period, meaning that you may want to smoke or vape more.

Combined with support, NRT products can lead to higher success rates when quitting.

Before using NRT, discuss the risks and benefits with your midwife, doctor, pharmacist or call Quitline on 13 78 48.

What NRT products are suitable for use in pregnancy?

The NRT products available to Pregnant Women provides information on how to use NRT correctly.

Oral forms

Gum, lozenges, mouth spray and inhalators. With all forms of oral NRT, nicotine is absorbed through the lining of the mouth. Oral forms of NRT provide nicotine faster than a nicotine patch.

Patches

Nicotine patches deliver nicotine through the skin at a steady rate. A patch takes about 6 hours to reach full blood nicotine concentration. During pregnancy, if using a 24-hour patch, remove it before bed and put on a fresh one each day, choosing a different place on your body for 4 to 5 days before using the same place again.

What NRT products aren't approved for use in pregnancy?

Buproprion (brand names Zyban SR and Prexaton) and Varenciline (brand name Champix) are not approved for use during pregnancy.

Nicotine vaping products have not been approved as a quit smoking aid in Australia, nor are any listed under the Australian Register of Therapeutic Goods. Current advice is that nicotine vaping products should not be the first smoking cessation approach you try.

Simple actions to take when you have the urge to smoke or vape

Follow the 4 'D's.

1. Delay acting on the urge to smoke. You should find that after 5 minutes, the urge to smoke lessens.
2. Deep breathe in and out slowly and deeply and repeat 3 times.
3. Drink water, taking slow sips and holding it in your mouth a little longer to savour the taste.
4. Do something else. This could mean talking to a friend, going for a walk, listening to music or anything else that will take your mind off your craving.

You can also try gentle exercises, such as walking, swimming or supervised yoga.

This should help you keep your mind off your cravings, and you'll also feel better after getting your body moving.