Smoking and women’s reproductive health

The key question

CDC reports that smoking can make becoming pregnant more difficult and contributes to reproductive harm. During pregnancy it can affect fetal growth and increase risks including preterm birth. Fertility concerns should not be reduced to one behavior or used to blame an individual. Smoking is a modifiable exposure within a broader health assessment. Quitting before pregnancy is beneficial, and quitting during pregnancy can still help; an earlier exposure is not a reason to give up. [1]

Separate nicotine from smoke exposure

Nicotine drives dependence, while tobacco smoke adds many toxic exposures. E-cigarettes have a different exposure profile, but aerosol is not simply harmless water. The relevant question is not only whether one product contains fewer substances than another: age, pregnancy, secondhand exposure, and continued cigarette use change the context. Avoiding initiation and supporting cessation are different conversations, and both should use clear information without blaming people who need help. [2]

Putting it into practice

Include tobacco exposure and quitting support in reproductive health care. [1]

Differences between products do not establish safety for children or during pregnancy. [2]