Stopping smoking in pregnancy: why it matters and the free help available

If you smoke and you’ve just found out you’re pregnant, you might be worried, or feel under pressure to stop overnight. Stopping is one of the best things you can do for your baby, and you don’t have to do it on your own. Free NHS help is there, and it makes stopping more likely to work.

Why stopping helps

Smoking in pregnancy raises the risk of complications, including premature birth and a low birthweight. Stopping lowers those risks, along with the risk of stillbirth and of sudden infant death syndrome (SIDS) after your baby is born.

It’s never too late. The benefits start straight away, and stopping even in the last few weeks of pregnancy still helps you and your baby.

This isn’t about blame. Stopping smoking is hard, which is exactly why there’s support for it. If you smoked before you knew you were pregnant, try not to dwell on it. What matters now is getting the help that suits you.

Free NHS help to stop

Getting help from a trained adviser roughly doubles your chances of stopping.

Ask your midwife or GP. They can refer you to your local NHS stop smoking service, which is free. You don’t need to wait to be asked.
What the service offers. 1-to-1 or group sessions, help with things like stress and weight gain, and support with using nicotine replacement therapy.
Helplines. In England, the National Smokefree helpline is 0300 123 1044 (9am to 8pm Monday to Friday, 11am to 4pm Saturday and Sunday). In Wales, Help Me Quit is 0800 085 2219. In Scotland, Quit Your Way is 0800 84 84 84. In Northern Ireland, visit Stop Smoking NI online or ask your midwife or GP.

The carbon monoxide test

Everyone is offered a carbon monoxide (CO) breath test at their booking appointment and again at 36 weeks, whether or not they smoke. Carbon monoxide is one of the 2 main toxins in cigarette smoke. The test isn’t there to catch you out. If you smoke, or stopped in the last 2 weeks, your midwife should refer you for support to stop.

In England, some maternity services offer shopping vouchers if you stop and stay smoke-free, worth up to £400 in total across pregnancy and the first months after birth. CO breath tests are used to check. Ask your midwife whether your area takes part.

Nicotine replacement therapy

You can use nicotine replacement therapy (NRT), such as patches, gum, lozenges, mouth spray or an inhalator, in pregnancy. It’s far less harmful than smoking, because it gives you nicotine to ease cravings without the tar, carbon monoxide and other chemicals in cigarette smoke.

A GP or NHS stop smoking adviser can prescribe it, or you can buy it from a pharmacy. In England, prescriptions are free while you’re pregnant if you have a maternity exemption certificate.
If you have pregnancy sickness, patches may suit you better. If your sickness is severe, see hyperemesis gravidarum.
Use patches for no more than 16 hours in any 24 hours, so take them off before bed.
Avoid liquorice-flavoured products; fruit or mint flavours are fine.
Stop smoking tablets such as varenicline, bupropion and cytisine (cytisinicline) aren’t recommended in pregnancy.

Talk to your midwife, GP, pharmacist or adviser before you start, so they can help you choose the right type for you. There’s more on medicines in medicines in pregnancy.

What about vaping?

Some people use a vape to help them stop smoking. Vaping is much less risky than smoking, but it’s unlikely to be completely risk-free, so if you don’t smoke, don’t start. Ask your stop smoking service about vapes: some offer them free in pregnancy. Vaping, fertility and pregnancy covers what’s known.

Second-hand smoke and partners

Other people’s smoke matters too. Breathing in second-hand smoke can reduce your baby’s birthweight and increase the risk of SIDS.

If your partner or someone you live with smokes, they can get free help from NHS stop smoking services, their GP or a pharmacist. If they’re not ready to stop, ask them not to smoke around you or inside your home.

After your baby is born, don’t let anyone smoke around your baby or in their room, and don’t share a bed with your baby if you or your partner smoke. See newborn sleep and safe sleep.

Cutting down, slips and stress

Cutting down is a start, but the best thing is to stop altogether. If you’ve cut down, tell your midwife or adviser. They can help you go the rest of the way, including with NRT for cravings.

If you slip and have a cigarette, it doesn’t mean you’ve failed or that there’s no point carrying on. Tell your adviser, who can help you work out what happened and get back on track.

If stress is what makes you reach for a cigarette, say so. Stop smoking services can help with stress as part of your plan. If you’re feeling very anxious or low, tell your midwife or GP too. See anxiety, low mood and loneliness in pregnancy.

Questions people ask

Can I use nicotine patches while pregnant?

Yes. Licensed NRT, including patches, can be used in pregnancy and is far less harmful than smoking. Use patches for no more than 16 hours in any 24.

Is cutting down enough?

Cutting down is a start, but stopping completely is best. An adviser can help you get there.

What is the carbon monoxide test in pregnancy?

It’s a breath test that checks for carbon monoxide, one of the main toxins in cigarette smoke. Everyone is offered it at their booking appointment and at 36 weeks, whether or not they smoke.

Can I get free help to stop smoking when pregnant?

Yes. NHS stop smoking support is free. Your midwife or GP can refer you, or you can call the helpline for where you live. In some parts of England you may also be offered vouchers for staying smoke-free.