Smoking and vaping during pregnancy

Smoking cigarettes and vapes (e-cigarettes) can affect fertility for both females and males.

Females who smoke or vape may:

• have difficulty conceiving (becoming pregnant)
• be at risk of early menopause
• be at higher risk of many cancers, including ovarian cancer
• have a lower supply of breast milk

Males who smoke or vape may have:

• trouble getting and maintaining an erection
• lower sperm count
• damage to the DNA in sperm, causing health problems in your baby

There is no safe amount of smoking or vaping during pregnancy.

Smoking during pregnancy exposes your baby to nicotine and harmful chemicals. These substances pass from you, through the placenta, to your baby's body. 

In Australia, vapes or e-cigarettes with 20 mg/mL or more of nicotine are only available by prescription from a pharmacist. All vapes contain other chemicals that can harm you or your baby, such as:

• acetone
• glycol
• formaldehyde

Smoking or vaping during pregnancy can result in a higher risk of pregnancy complications, such as:

• miscarriage
• stillbirth
• premature birth
• low birth weight
• birth differences, such as cleft lip and palate
• damage to your baby's heart and lungs

If you are exposed to smoking during pregnancy, your baby has a higher risk of developing health problems. These include:

• lung conditions such as asthma, wheezing (Opens in new tab), bronchiolitis (Opens in new tab) 
• middle ear infections or hearing problems
• sudden infant death syndrome (SIDS)

Exposure to second-hand smoke may also increase your child’s risk of:

• allergies
• childhood cancers
• developmental issues
• weight problems
• dental problems
• sudden infant death syndrome (SIDS)

The risks of vaping while pregnant are still being researched, but current research shows that vaping and e-cigarette use are not safe during pregnancy.

Smoking or vaping can pass harmful chemicals to your baby through your breast milk. 
It is important to try to quit. If you cannot quit smoking or vaping, your healthcare provider can support you with ways to reduce or change your smoking or vaping habits while you continue breastfeeding. 

Even if you do continue to smoke or vape, try to exclusively breastfeed your baby for around their first 6 months. It is best to wait a few hours after smoking before breastfeeding. This will reduce your baby’s exposure to nicotine and other chemicals found in cigarettes.

Passive smoking, or second-hand smoking, puts both you and your baby at risk of harm.

If your partner or others in your household are not ready to quit, ask them to smoke outside the house or car.

It is illegal to smoke in a car with children.

The best way to protect yourself and your baby is to quit smoking and vaping.

There are many ways to quit. You may need to try a few different methods before you find one that works for you. Every attempt to give up cigarettes or vaping is a step towards becoming an ex-smoker. You may try:

• stopping all at once (‘cold turkey’) — this works for many people
• cutting down how much you smoke over time, until you stop completely

Tips to help you quit include:

• talking to your doctor
• calling support services like Quitline (Opens in new tab)
• avoiding situations that may make you want to smoke or vape (such as pubs or bars)
• asking your family and friends for support

Having a good support network can also help you manage withdrawal symptoms.

Your doctor can also refer (Opens in new tab) you for counselling to help you quit smoking.

There are treatments available to help you quit smoking or vaping.

Nicotine replacement therapies

Nicotine replacement therapies (NRT) may help you quit. They are available from pharmacies and some supermarkets. There are 2 types of NRT:

1. long-acting (steady-release) products, such as nicotine patches 
2. fast-acting (quick-response) products, such as chewing gum, lozenges, tablets and inhalers

NRT products are safer than smoking, but they can still be harmful to your baby. It's important to discuss the risks and benefits with your doctor or pharmacist and follow their advice.

If you are pregnant and trying to quit, your doctor or pharmacist may recommend specific NRT products, such as:

• lozenges
• mouth spray
• gum
• inhalers

These usually provide a lower daily dose of nicotine than the patch. If you have side effects from these, such as nausea, you may prefer the patch.

You can use the daytime patch to help you quit, but you should remove it before going to bed. You should not use the 24-hour nicotine patch during pregnancy.

Prescription medicines

There are some prescription medicines that can help manage withdrawal symptoms, such as:

• varenicline
• bupropion

These are not recommended if you are pregnant or breastfeeding. They may be suitable for other members of your household.

Can vapes help me quit smoking?

There is limited evidence that vaping is an effective or safe way to quit smoking. Vaping is sometimes considered less harmful than smoking, but it is not risk-free. Vaping still exposes you and your baby to harmful chemicals. 

Vapes are not recommended as the first-choice treatment to help quit smoking. To give up smoking or vaping, speak with your doctor or pharmacist first. They can advise you how to quit based on your circumstances.

There is no evidence that low-tar, roll-your-own or natural tobacco cigarettes are safer for you or your baby than regular cigarettes.

It is also not recommended to switch to cannabis (marijuana) instead of smoking. Smoking cannabis during pregnancy is linked to having a baby with low birth weight.

To help you quit smoking, there are resources available, such as:

• The Lung Foundation Australia website on quitting smoking (Opens in new tab).
• The Department of Health, Disability and Ageing website on helping someone to quit (Opens in new tab).
• Quitline (Opens in new tab) — call 13 QUIT (13 7848) to speak with a counsellor or request a callback
• Mobile apps, such as My QuitBuddy (Opens in new tab)

There are also quitting resources specific to different states, such as:

• Australian Capital Territory — Get help to quit (Opens in new tab)
• New South Wales — ICanQuit (Opens in new tab)
• Northern Territory — Smoking (Opens in new tab)
• Queensland — Quit HQ (Opens in new tab)
• South Australia — Be smoke free (Opens in new tab)
• Tasmania — Quit Tasmania (Opens in new tab)
• Victoria — Quit Victoria (Opens in new tab)
• Western Australia — Make smoking history (Opens in new tab)

Languages other than English

There are organisations that can help you if you speak a language other than English:

• The Multicultural Health Communication Service — quit smoking (Opens in new tab) resource.
• Quitline can arrange a telephone interpreter for you — call 13 7848. They also offer smoking and vaping resources for culturally and linguistically diverse communities (Opens in new tab).
• The Australian Government has translated resources (Opens in new tab) to help you quit smoking.

Information for Aboriginal and/or Torres Strait Islander peoples

There are culturally appropriate services and resources to support you to quit smoking:

• Aboriginal Quitline (Opens in new tab) offers a dedicated service to Aboriginal and/or Torres Strait Islander peoples with Aboriginal and/or Torres Strait Islander counsellors available. You can access this service by calling 13 78 48 from anywhere in Australia. 
• Tackling Indigenous Smoking (TIS) provides resources for Aboriginal and Torres Strait Islander people including pregnant women and families (Opens in new tab) who are trying to quit smoking. 
• The Royal Women’s Hospital has resources (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples who are pregnant and their families.

Information for sexually and gender-diverse families

Can We (Opens in new tab) provides information on how to quit smoking for sexually and gender-diverse families.