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Stanford University School of Medicine

Quitting smoking for the baby you plan to have together

My best friend finally succeeded in his efforts to stop smoking when he experienced a highly motivating life change: Fatherhood. Likewise, many women discover that wanting to have a safe and healthy pregnancy gives them unprecedented desire to kick their tobacco habit. Knowing the research and clinical evidence may be useful to parents-to-be who have some questions about smoking:

  1. Quitting smoking is very hard – does it really make enough difference to be worth it?  Yes. To get one sense of the impact of smoking on fetal development, recall the widespread panic in the 1980s about “crack cocaine babies." Subsequent research has shown that the damage to fetuses of cigarette smoking is in fact worse than that of crack cocaine use. Even if it didn’t benefit the fetus (and later, the infant) for a mother to quit smoking, it would still be worth using the extra motivation to quit that pregnancy provides for the sake of the mother’s long term health.
  2. When is the best time to try to quit? Early. In an excellent lecture I saw last week, Professor Zachary Stowe, MD, with the University of Arkansas for Medical Sciences, pointed out that the soonest a woman can know she is pregnant is 4-6 weeks after conception, at which point fetal organogenesis is well underway. Further, Stowe and other researchers have conducted research identifying nicotine and its metabolites in the fetal compartment even after the mother has stopped smoking. Dr. Stowe therefore suggests that rather than waiting to quit until after stopping birth control or after pregnancy has been confirmed by a test, a mother-to-be should wait two weeks after quitting smoking before going off birth control. Note: Even if you didn’t do this, quitting smoking at any point later in the pregnancy is still good for the fetus (and for you too).
  3. I smoke, but I’m not carrying the baby, so why does it matter whether I quit? This isn’t just about mom. Passively absorbed smoke contributes to nicotine in the fetal compartment, meaning that even if the mother quits, smoking by her partner may affect the fetus. Also, an added benefit to a couple of quitting together is suggested by research and clinical experience in addiction treatment: Relapse is more likely when the visible, auditory and olfactory cues of substance use remain in the environment. Hence, a mom-to-be is going to have a much harder time quitting cigarettes if her partner remains a smoker. More positively, if two people quit together they can remove those cues from the environment and also have built-in social support for resisting the cravings they both may experience.
  4. Where can we get help with smoking cessation? Free resources are just a click away here. If you need extra support, consult your physician, who can help you both with smoking cessation and with other conditions you may have (e.g., depression) that make it hard to quit.

Addiction expert Keith Humphreys, PhD, is a professor of psychiatry and behavioral sciences at Stanford and a career research scientist at the Palo Alto VA. He recently completed a one-year stint as a senior advisor in the Office of National Drug Control Policy in Washington.

Previously: Craving a cigarette but trying to quit? A supportive text message might help, Exercise may help smokers kick the nicotine habit and remain smoke-free, Kicking the smoking habit for good and Can daily texts help smokers kick their nicotine addiction?
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