Pregnancy

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Smoking in pregnancy

Australia

• Australian Family Physician
  • Management of smoking in pregnant women [2014]

• Australian Institute of Health and Welfare
  • Smoking during pregnancy

• BMC Medicine
  • Use of smoking cessation pharmacotherapies during pregnancy is not associated with increased risk of adverse pregnancy outcomes: a population-based cohort study [2020]

• BMJ Open
  • Benefits of not smoking during pregnancy for Australian Aboriginal and Torres Strait Islander women and their babies: a retrospective cohort study using linked data [2019]

• Implementation Science Communications
  • Improving implementation of smoking cessation guidelines in pregnancy care: development of an intervention to address system, maternity service leader and clinician factors [2021]

• International Journal of Environmental Research and Public Health
  • Improving Clinicians’ Implementation of Guidelines to Help Women Stop Smoking in Pregnancy: Developing Evidence-Based Print and Video Materials [2021]
  • Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey [2017]

• Journal of the American Heart Association
  • Maternal Smoking Intensity During Pregnancy and Early Adolescent Cardiovascular Health [2025]

• Nicotine & Tobacco Research
  • Provision of antenatal smoking cessation support: a survey with pregnant Aboriginal and Torres Strait Islander women [2015]

• NSW Health
  • Reducing the effects of smoking and vaping on pregnancy and newborn outcomes

• Quit Centre
  • Supporting Smoking Cessation in Pregnancy and Breastfeeding – Guideline [2024]

• Royal Australian and New Zealand College of Obstetricians and Gynaecologists
  • Supporting smoking cessation during pregnancy – nicotine replacement therapy (NRT) Health services version [2020]
  • Supporting smoking cessation during pregnancy – nicotine replacement therapy (NRT) General practice version [2020]

• SA Health
  • Smoking (Tobacco) and Vaping in Pregnancy

Australia, New Zealand

• Perinatal Society of Australia and New Zealand
  • Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting [2020]
  • Position statement: Smoking – one of the most important things to prevent in pregnancy and beyond [2019]

• Royal Australian and New Zealand College of Obstetricians and Gynaecologists
  • Smoking and pregnancy [2020]

Brazil

• Nicotine & Tobacco Research
  • Smoking and Adverse Maternal and Child Health Outcomes in Brazil [2013]

• PLoS ONE
  • Prevalence of pre-gestational and gestational smoking and factors associated with smoking cessation during pregnancy, Brazil, 2011-2012 [2019]

• Revista Latino-Americana de Enfermagem
  • Activities of the healthcare team for women who smoke during pregnancy and the puerperium [2014]

Canada

• Canadian Family Physician
  • Smoking cessation therapy during pregnancy [2012]

• Journal of Obstetrics and Gynaecology Canada
  • Smoking cessation during pregnancy and relapse after childbirth in Canada [2015]
  • Smoking Cessation Strategies in Pregnancy [2015]

• PLoS ONE
  • Smoking during Pregnancy: Findings from the 2009–2010 Canadian Community Health Survey [2014]

• Public Health Agency of Canada
  • Smoking Cessation During Pregnancy And Relapse After Childbirth In Canada

Central America and the Caribbean

• Nicotine & Tobacco Research
  • Predictors of Secondhand Smoke Exposure During Pregnancy in Costa Rica, the Dominican Republic, and Honduras [2022]

Chile

• International Journal of Public Health
  • Smoking Ban Law in Chile: Impact in Newborns' Birth Weight by Women's Age Groups and by City Population Density [2022]

China

• Health and Quality of Life Outcomes
  • Maternal tobacco exposure and health-related quality of life during pregnancy: a national-based study of pregnant women in China [2021]

• JMIR Public Health and Surveillance
  • Health-Related Quality of Life Among Pregnant Women With Pre-pregnancy Smoking and Smoking Cessation During Pregnancy in China: National Cross-sectional Study [2022]

• Preventing Chronic Disease: Public Health Research, Practice and Policy
  • Exposure to Secondhand Tobacco Smoke and Interventions Among Pregnant Women in China: A Systematic Review [2015]

Denmark

• Philosophical Transactions of the Royal Society B: Biological Sciences
  • Variable DNA methylation in neonates mediates the association between prenatal smoking and birth weight [2019]

Europe

• BMC Medicine
  • In utero and childhood exposure to tobacco smoke and multi-layer molecular signatures in children [2020]

Europe, United States

• American Journal of Human Genetics
  • DNA Methylation in Newborns and Maternal Smoking in Pregnancy: Genome-wide Consortium Meta-analysis [2016]

• BMC Pregnancy and Childbirth
  • Vaping during pregnancy: a systematic review of health outcomes [2024]

• Harm Reduction Journal
  • Potential effects of using non-combustible tobacco and nicotine products during pregnancy: a systematic review [2020]

Finland

• BMC Pregnancy and Childbirth
  • The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study [2020]

• BMJ Open
  • Associations between maternal age and socioeconomic status with smoking during the second and third trimesters of pregnancy: a register-based study of 932 671 women in Finland from 2000 to 2015 [2020]
  • Changes in objectively measured smoking in pregnancy by time and legislative changes in Finland: a retrospective cohort study [2016]

France

• International Journal of Public Health
  • Trends in Tobacco Smoking in Pregnant Women: Data From French National Perinatal Surveys [2021]

• Journal of Gynecology Obstetrics and Human Reproduction
  • Smoking and smoking cessation in pregnancy. Synthesis of a systematic review [2020]

• Journal of Preventive Medicine and Hygiene
  • Smoking during pregnancy: a difficult problem to face. Results of a French multi-center study [2016]

Germany

• Robert Koch Institute
  • Smoking during pregnancy. Results of the cross-sectional KiGGS Wave 2 study and trends – Fact sheet [2018]

High-income countries

• Cochrane Database of Systematic Reviews
  • Pharmacological interventions for promoting smoking cessation during pregnancy [2020]
  • Factors influencing the uptake and use of nicotine replacement therapy and e-cigarettes in pregnant women who smoke: a qualitative evidence synthesis [2020]

• International Journal of Environmental Research and Public Health
  • Safety of Nicotine Replacement Therapy during Pregnancy: A Narrative Review [2022]

• Women's Health
  • Facilitators and barriers to substance-free pregnancies in high-income countries: A meta-synthesis of qualitative research [2022]

Iceland

• European Journal of Public Health
  • Smoking and obesity among pregnant women in Iceland 2001–2010 [2015]

• Scandinavian Journal of Primary Health Care
  • Smoking during pregnancy: Childbirth and Health Study in Primary Care in Iceland [2014]

India

• Asian Pacific Journal of Cancer Prevention
  • Smokeless Tobacco Use among Pregnant Women in India: The Tale of Two Nationally Representative Surveys [2022]

• Frontiers in Public Health
  • Prevalence and factors associated with tobacco use among pregnant and breastfeeding mothers in India: insights from the National Family Health Survey-5 (2019-21) [2025]

International

• Acta Obstetricia et Gynecologica Scandinavica
  • Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta-analysis [2025]

• Acta Paediatrica
  • Vaping and Smoking in Pregnancy-A Meta-Analysis of Neurobehavioural Development in Prenatally Exposed Offspring [2025]

• BMC Pregnancy and Childbirth
  • Health providers’ and pregnant women’s perspectives about smoking cessation support: a COM-B analysis of a global systematic review of qualitative studies [2021]
  • Health outcomes of smoking during pregnancy and the postpartum period: an umbrella review [2021]

• BMJ Open
  • What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis [2019]
  • Systematic critical review of previous economic evaluations of smoking cessation during pregnancy [2015]

• Cochrane Database of Systematic Reviews
  • Psychosocial interventions for supporting women to stop smoking in pregnancy [2017]

• International Journal of Environmental Research and Public Health
  • Special Issue on the Effects of Prenatal Smoking/Nicotine Exposure on the Child’s Health [2021]

• Lancet Global Health
  • National, regional, and global prevalence of smoking during pregnancy in the general population: a systematic review and meta-analysis [2018]

• PLoS ONE
  • The association between maternal tobacco smoking during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring: A systematic review and meta-analysis [2025]
  • The invisible enemy: A systematic review and meta-analysis of maternal smokeless tobacco use as a risk factor for low birth weight [2024]

Japan

• Environmental Research
  • Evaluating association of smoking status during pregnancy with adverse birth outcomes using urinary cotinine concentration: The Japan environment and Children's study (JECS) [2022]
  • Dose-response relationships between maternal urinary cotinine and placental weight and ratio of placental weight to birth weight: The Japan Environment and Children's Study [2022]

• International Journal of Environmental Research and Public Health
  • Association between Heated Tobacco Product Use during Pregnancy and Fetal Growth in Japan: A Nationwide Web-Based Survey [2022]
  • Determination of Urinary Cotinine Cut-Off Concentrations for Pregnant Women in the Japan Environment and Children’s Study (JECS) [2020]
  • Individual and Regional Characteristics Associated with Maternal Smoking During Pregnancy in Japan: Healthy Parents and Children 21 [2019]

• Scientific Reports
  • Decreased head circumference at birth associated with maternal tobacco smoke exposure during pregnancy on the Japanese prospective birth cohort study [2021]

Jordan

• PLoS ONE
  • Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities [2021]

Netherlands

• BMC Health Services Research
  • Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers [2019]
  • Government supervision on quality of smoking-cessation counselling in midwifery practices: a qualitative exploration [2017]

• BMC Pregnancy and Childbirth
  • Women who smoke during pregnancy are more likely to be referred to an obstetrician during pregnancy and birth: results from a cohort study [2022]

New Zealand

• Ministry of Health New Zealand
  • The New Zealand Guidelines for Helping People to Stop Smoking Update [2021]

Papua New Guinea

• PLoS ONE
  • Cigarette smoking during breastfeeding in Papua New Guinea: Prevalence and demographic and socio-economic predictors [2022]

Peru

• Global Health Research and Policy
  • The impact of anti-tobacco legislation on birth weight in Peru [2020]

South Africa

• International Journal of Preventive Medicine
  • Maternal Tobacco use during Pregnancy in South Africa: Results from a National Population-based Survey [2019]

Spain

• Archivos de Bronconeumología
  • Clinical Practice Guideline of Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on Pharmacological Treatment of Tobacco Dependence 2023 [2023]

Sweden

• BMC Medicine
  • Maternal smoking during pregnancy and type 1 diabetes in the offspring: a nationwide register-based study with family-based designs [2022]

• BMJ
  • Maternal smoking during pregnancy and fractures in offspring: national register based sibling comparison study [2020]

• European Journal of Public Health
  • Smoking during pregnancy among immigrants to Sweden, 1992–2008: the effects of secular trends and time since migration [2013]

• International Journal of Epidemiology
  • Maternal smoking and smokeless tobacco use during pregnancy and offspring development: sibling analysis in an intergenerational Swedish cohort [2021]

• Nicotine & Tobacco Research
  • Smoking During Pregnancy Among Immigrant Women With Same-Origin and Swedish-Born Partners [2021]

United Kingdom

• Action on Smoking and Health
  • Smoking in Pregnancy Challenge Group

• Addiction
  • Financial incentives for quitting smoking in pregnancy: Are they cost-effective? [2023]
  • Investigating the cost-effectiveness of three cessation interventions on a national scale using the Economics of Smoking in Pregnancy (ESIP) decision analytical model [2022]

• Addictive Behaviors
  • Smoking and vaping patterns during pregnancy and the postpartum: A longitudinal UK cohort survey [2021]

• Addictive Behaviors Reports
  • Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey [2019]

• Health Technology Assessment
  • Helping pregnant smokers quit: a multi-centre randomised controlled trial of electronic cigarettes versus nicotine replacement therapy [2023]

• International Journal of Environmental Research and Public Health
  • Smoking Cessation Support for Pregnant Women Provided by English Stop Smoking Services and National Health Service Trusts: A Survey [2022]
  • Attitudes to E-Cigarettes and Cessation Support for Pregnant Women from English Stop Smoking Services: A Mixed Methods Study [2019]

• International Journal of Epidemiology
  • Using a cross-cohort comparison design to test the role of maternal smoking in pregnancy in child mental health and learning: evidence from two UK cohorts born four decades apart [2020]

• National Centre for Smoking Cessation and Training
  • Pregnancy

• National Institute for Health and Care Excellence
  • Tobacco: preventing uptake, promoting quitting and treating dependence [2025]

• NHS Digital
  • Statistics on Women's Smoking Status at Time of Delivery: England

• NHS England
  • Greater Manchester Smokefree Pregnancy Guideline and Care Pathway [2023]

• Obstetrician & Gynaecologist
  • Smoking in pregnancy: pathophysiology of harm and current evidence for monitoring and cessation [2019]

• PLoS ONE
  • Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England [2021]
  • Women’s Longitudinal Patterns of Smoking during the Pre-Conception, Pregnancy and Postnatal Period: Evidence from the UK Infant Feeding Survey [2016]

• Population Health Metrics
  • Small area synthetic estimates of smoking prevalence during pregnancy in England [2015]

• Public Health England
  • Characteristics of women who stop smoking in pregnancy

• Royal College of Paediatrics and Child Health
  • Smoking during pregnancy

• WISDOM
  • Guidelines for supporting women who smoke during pregnancy [2025]
  • Guideline for Smoking Cessation in Pregnancy [2025]
  • Maternal Smoking Cessation Programme Guideline and Pathway [2024]

United States

• Agency for Healthcare Research and Quality
  • Interventions for Tobacco Cessation in Adults, Including Pregnant Women: An Evidence Update for the U.S. Preventive Services Task Force [2021]

• American College of Obstetricians and Gynecologists
  • Tobacco and Nicotine Cessation During Pregnancy [2020]

• BMC Medicine
  • Maternal cigarette smoking before or during pregnancy increases the risk of birth congenital anomalies: a population-based retrospective cohort study of 12 million mother-infant pairs [2022]

• BMC Pregnancy and Childbirth
  • Trends in smoking during pregnancy by socioeconomic characteristics in the United States, 2010–2017 [2020]
  • Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data [2020]

• Cardiovascular Toxicology
  • The Impact of Maternal/In Utero Exposure of Novel Tobacco Products on the Offspring Cardiovascular Health [2025]

• Centers for Disease Control and Prevention
  • Cigarette Smoking Among Pregnant Women During the Perinatal Period: Prevalence and Health Care Provider Inquiries — Pregnancy Risk Assessment Monitoring System, United States, 2021 [2024]
  • Declines in Cigarette Smoking During Pregnancy in the United States, 2016-2021 [2023]
  • Maternal periconceptional alcohol consumption and gastroschisis in the National Birth Defects Prevention Study, 1997-2011 [2022]
  • Maternal Smoking and Congenital Heart Defects, National Birth Defects Prevention Study, 1997-2011 [2022]
  • Smoking Prevalence and Cessation Before and During Pregnancy: Data From the Birth Certificate, 2014 [2016]
  • Maternal and Infant Care Settings and Smoking Cessation
  • Health Effects of Cigarettes: Reproductive Health

• JAMA Network Open
  • Cigarette Smoking Abstinence Among Pregnant Individuals Using E-Cigarettes or Nicotine Replacement Therapy [2023]

• Maternal and Child Health Journal
  • Investigating the Role of Race and Stressful Life Events on the Smoking Patterns of Pregnant and Postpartum Women in the United States: A Multistate Pregnancy Risk Assessment Monitoring System Phase 8 (2016-2018) Analysis [2023]

• Nicotine & Tobacco Research
  • Demographic Characteristics, Perinatal Smoking Patterns, and Risk for Neonatal Health Complications Among Pregnant Smokers in the United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data [2024]
  • Birth Outcomes Associated With E-Cigarette and Non-E-Cigarette Tobacco Product Use During Pregnancy: An Examination of PATH Data Waves 1-5 [2023]

• Pediatrics
  • Maternal Smoking Before and During Pregnancy and the Risk of Sudden Unexpected Infant Death [2019]

• PLoS Medicine
  • Maternal cigarette smoking before and during pregnancy and the risk of preterm birth: A dose–response analysis of 25 million mother–infant pairs [2020]

• PLoS ONE
  • Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: A cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population [2023]

• Preventive Medicine
  • Smoking Prevalence Among U.S. National Samples of Pregnant Women [2020]
  • Decreasing smoking during pregnancy: Potential economic benefit of reducing sudden unexpected infant death [2020]
  • Nicotine replacement therapy and other interventions for pregnant smokers: Pregnancy Risk Assessment Monitoring System, 2009–2010 [2015]

• Preventive Medicine Reports
  • Social determinants of smoke exposure during pregnancy: Findings from waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study [2018]
  • Clinicians’ awareness of the Affordable Care Act mandate to provide comprehensive tobacco cessation treatment for pregnant women covered by Medicaid [2015]

• Reproductive Health
  • Prevalence and patterns of cigarette smoking before and during early and late pregnancy according to maternal characteristics: the first national data based on the 2003 birth certificate revision, United States, 2016 [2019]

• SSM - Population Health
  • Disparities in smoking during pregnancy by sexual orientation and race-ethnicity [2021]

• U.S. Preventive Services Task Force
  • Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions [2021]

Western countries

• Women and Birth
  • Is carbon monoxide testing in pregnancy an acceptable and effective smoking cessation initiative? An integrative systematic review of evidence [2024]

WHO

• World Health Organization
  • Tobacco and stunting [2025]
  • WHO clinical treatment guideline for tobacco cessation in adults [2024]
  • Tobacco control to improve child health and development: thematic brief [2021]
  • WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy [2013]
  • Gender, women, and the tobacco epidemic [2010]

{Related topics}

• Topic
  • Obstetrics, perinatology