Pregnancy may increase the importance of quitting smoking, but it does not necessarily increase the ability to quit. According to 2003, 2004, and 2005 statistics, approximately 21% of women who delivered a baby at Peterborough Regional Health Centre or in their own home under the care of a midwife, smoked cigarettes after 20 weeks of pregnancy.  This concludes that approximately 1 in 5 Peterborough women smoke during their pregnancy; which is extremely high compared to the provincial average of 1 in 10. 

Some women are able to quit during pregnancy, however resume smoking after the baby is born.  Returning to smoking is common as 50-60% of those that quit during pregnancy will return to smoking within six months postpartum.

Facts About Quitting During Pregnancy

Myths	Facts
Quitting smoking during pregnancy is too stressful on the baby.	Smoking during pregnancy is more harmful to the fetus and the mother than quitting during pregnancy. All pregnant women should be advised to quit smoking.
Smaller babies are easier to deliver.	It is not always easier to deliver a low-birth weight baby and a baby that weighs too little is often sick with many health problems.
It's too late to do any good.	It's never too late to quit.  Even if a woman quits at the end of her pregnancy, she can help her baby get more oxygen and have a better chance of living.
Smoking "light" cigarettes is safer than "regular" cigarettes.	No cigarette is safe for a pregnant women and her fetus.  Depending on the length of inhalation, light cigarettes can be more harmful than regular.
It will be easier to quit after the baby is born.	Parenting a newborn baby can be stressful.  It is better for the woman to quit before the baby is born.
Nicotine Replacement Therapy (NRT) (i.e., patch, gum) is not safe to use during pregnancy.	Straight nicotine from NRT is safer for mother and fetus compared to cigarette smoke, especially in the 2nd and 3rd trimester.  For pregnant women who are heavy smokers, NRT should be used when they are unable to quit smoking on their own.  Using NRT will prevent hypoxic effects associated with cigarette use and will protect the woman and her fetus from carbon monoxide and hydrogen cyanide exposure.  Pregnant women who are light smokers should be counselled to quit without using NRT.

Counselling a Pregnant Woman to Quit Smoking
Use the Ask, Advise, Assist, Arrange protocol when counselling a pregnant women:

1. Ask all pregnant patients if they smoke cigarettes.  If she says no, ask her if she has already quit.  Women who quit during pregnancy are extremely vulnerable and usually relapse back to smoking within six months postpartum.  Offer support to any woman that has already quit.
2. For patients that still smoke, ask how many cigarettes they smoke per day.
3. Advise clearly about the benefits of quitting, especially highlighting the benefits for the mother.
4. Assist each woman in quitting by providing counselling, and resources.
5. Arrange for each woman to access support, such as Motherisk, Smokers’ Helpline or Pregnets.  To make it easier for the woman, use the Smokers’ Helpline faxback form.

(Click here for more information in the 4As Protocol)

REMEMBER: Quitting smoking during pregnancy does not harm the fetus.  ALL pregnant women that smoke must be counselled to quit.

For More Information:
 
 

Smoker's Helpline 1-877-513-5333 www.smokershelpline.ca	Pregnets www.pregnets.org
Motherisk 1-877-327-4636 www.motherisk.org	This website gives you access to a health professionals' screening tool for pregnant women, a desk reference card, a pros and cons quitting tool, and a patient resource card.
Ontario Medical Association Rethinking Stop-Smoking Medications:  Myths and Facts www.oma.org/Health/tobacco/stopsmoke.asp	Peterborough County-City  Health Unit (705) 743-1000 www.pcchu.ca

Information in this section was adapted from www.pregnets.org