Smoking and Reproductive Health: Pregnancy, Fertility and Secondhand Smoke

At a glance

• Smoking before or during pregnancy can cause serious health problems for the pregnant woman and her baby.
• Secondhand smoke is harmful during pregnancy and after the baby is born.
• Smoking can cause fertility problems in both women and men.
• Quitting at any point in pregnancy helps protect the woman's health and gives the baby a healthier start.

Smoking and pregnancy

Smoking can cause complications in pregnancy and harm the health of both the pregnant woman and her baby:

• Complications. Smoking doubles the risk of abnormal bleeding during pregnancy and delivery, which is dangerous for mother and baby. Other complications include early rupture of the membranes, placenta previa, placental abruption and ectopic pregnancy.
• Stillbirth — the loss of a baby after the 20th week of pregnancy or during birth — is more likely.
• Poor growth and low birth weight. Smoking slows the baby's growth, and a baby can be born too small even after a full-term pregnancy.
• Preterm birth, before 37 weeks. Premature babies often have health problems.
• Damage to the baby's developing lungs and brain, which can last through childhood and into the teenage years.
• Birth defects, including cleft lip, cleft palate or both. A cleft is an opening in the lip or the roof of the mouth; a baby with a cleft lip can have trouble feeding and will likely need surgery.
• Sudden infant death syndrome (SIDS), the sudden, unexplained death of a baby.

Smoking and fertility

Smoking can make it harder for women to become pregnant and raises the risk of never becoming pregnant. It also damages sperm and can lead to impotence (erectile dysfunction), both of which can make it harder to father a child.

Secondhand smoke

• During pregnancy, secondhand smoke causes lower birth weight and may cause preterm birth.
• Babies exposed to it are at higher risk of SIDS, ear infections, lung infections and reduced lung function.

Quitting helps

The best time to quit is before trying to get pregnant; the next best is as early in pregnancy as possible. But quitting at any point in pregnancy helps. Quitting:

• during pregnancy reduces smoking's effects on the baby's growth;
• before or early in pregnancy lowers the risk of a small or low-birth-weight baby;
• may also lower the risk of preterm birth and early menopause.

For free help to quit, visit CDC.gov/quit.

Sources

• Centers for Disease Control and Prevention, "Health Effects of Cigarettes: Reproductive Health," January 31, 2025. https://www.cdc.gov/tobacco/about/cigarettes-and-reproductive-health.html