Pregnancy and Quitting Tobacco

Whether you are looking to quit or reduce, setting a date can motivate you to take action. Mark it on your calendar and tell your support network. This can help keep you committed to your goals. 

At the beginning of your quit journey, you may experience unpleasant effects known as withdrawal symptoms. This is completely normal. Withdrawal symptoms will fade over time as your body adjusts to being tobacco-free. While the best time to quit is before pregnancy, quitting or reducing smoking at any point in your pregnancy will bring you and your baby many health benefits.*

Learn ways to handle withdrawal symptoms.

*Note: It is safe and recommended to quit at any point during pregnancy. If you are taking any medications, talk to your healthcare provider about how quitting or reducing nicotine can fit best with your treatment plan. If you are managing conditions such as gestational diabetes, hypertension, or a high-risk pregnancy, quitting tobacco can also improve outcomes. Your provider may have additional guidance tailored to your situation.

• Behavioural support: We are here to support you whether you are starting to think about quitting or reducing, ready to make a quit plan, or need support with slips and relapses. Our Quit Coaches provide one-on-one guidance to help you explore your goals and motivations, discuss ways to handle cravings and withdrawal symptoms, and help you navigate challenges.

Call a Quit Coach 

Chat live with a Quit Coach 

Get Text and Email Tips  

• Gradual reduction: Gradually reducing the number of cigarettes or other tobacco products you use each day can make the transition to being tobacco-free more manageable. Quitting completely is the best way to protect you and your baby’s health. But every step you take to cut down can lower health risks for you and your baby.
• Quit aids: Behavioural support and gradual reduction are recommended ways to help you quit or reduce tobacco during pregnancy. But if you have tried before and not had success, you can consult your health care provider or pharmacist to understand if nicotine replacement therapy (NRT), such as patches or gum, are suitable for you. Using NRT is safer than continuing to smoke or vape.

• Identify your triggers: Triggers are situations, people, or places that bring up the desire to smoke or vape. Identifying your triggers can help you create a plan to manage them. For example, if you find yourself often smoking or vaping after drinking coffee, try switching to an herbal, decaffeinated tea.* 

  Learn more about smoking and vaping triggers 

  *If you are pregnant and use coffee as part of your routine, try switching to decaf or herbal tea options. Health Canada recommends pregnant individuals to keep their caffeine intake to no more than 300 mg/day, or about two 8-oz cups of coffee.

Pregnancy also comes with unique high-stress triggers that can make cravings feel stronger. You may notice increased urges to smoke and vape during moments of:

• Nausea or physical discomfort
• Fatigue or low energy
• Disrupted sleep or troubles falling asleep
• Stress from medical appointments or test results
• Relationship or co-parenting stress
• Grief, fear, or anxiety around birth planning

These experiences are completely normal during pregnancy. Identifying when cravings tend to show up can help you prepare supportive strategies in advance — and our Quit Coaches can help you build a plan that works for you.

A strong support network can help you stay motivated and committed on your quit journey. Talk to the people you trust, such as your partner, family members, and friends, and think of ways they could support you.Examples include:

• Distracting you when cravings hit (e.g., going for a walk together)
• Avoiding things that trigger you when together (e.g., alcohol, coffee)
• Listening and providing emotional support
• Providing encouragement when you experience a slip
• Joining your appointments with your health care provider

If someone else in your life smokes or vapes, you can encourage them to quit or reduce with you or ask that they avoid using the products in your home and car. A smoke-free home can prevent triggers and second-hand smoke exposure for you or your baby.

You are not alone! We have a supportive online community of peers and Quit Coaches who are ready to listen to your experiences, share quit tips and strategies, and celebrate your progress.

Attend Group Support Sessions

Join Community Forum

Hormonal changes throughout pregnancy and after giving birth bring unique challenges in your journey to quit or reduce nicotine, and we are here to support you through the process. It may take several tries to quit for good. But with each attempt, you are closer to being tobacco-free.

The major life changes that come with caring for a new baby along with mental wellbeing challenges such as postpartum depression or anxiety can make it harder to stay tobacco-free. The postpartum period is one of the most vulnerable times for returning to tobacco use. Lack of sleep, stress, fatigue, and mood shifts can all strengthen cravings. You’re not alone, this is extremely common and never a sign of failure. If you end up returning to or increasing tobacco use, go easy on yourself. Take a look at our resources for dealing with slips and relapses, rely on your support network, and call a Quit Coach for extra support.

1. White, A. M., Craig, A. J., Richie, D. L., Corley, C., Sadek, S. M., Barton, H. N., & Gipson, C. D. (2024). Nicotine is an immunosuppressant: Implications for women’s health and disease. Journal of Neuroimmunology, 397, 578468. https://doi.org/10.1016/j.jneuroim.2024.578468

2. Health Canada. (2023). Health effects of smoking: Diseases, conditions and other health effects. Government of Canada. https://www.canada.ca/en/health-canada/services/smoking-tobacco/health-effects-smoking-second-hand-smoke/diseases-conditions.html

3. Beckodro, C. K., Conteh, V., Nsitou, B., Das, S., Sullivan, K., & Cowan, L. T. (2025). Tobacco smoking and postpartum depression symptoms in the Pregnancy Risk Assessment and Monitoring System (PRAMS) study. Journal of Affective Disorders, 383, 222–227. https://doi.org/10.1016/j.jad.2025.04.147

4. Harlev, A., Agarwal, A., Gunes, S. O., Shetty, A., & Du Plessis, S. S. (2015). Smoking and male infertility: An evidence-based review. The World Journal of Men’s Health, 33(3), 143. https://doi.org/10.5534/wjmh.2015.33.3.143

5. Dhage, V. D., Nagtode, N., Kumar, D., & Bhagat, A. K. (2024). A narrative review on the impact of smoking on female fertility. Cureus, 16(4), e58389. https://doi.org/10.7759/cureus.58389

6. Nordenstam F. (2021). Prenatal nicotine exposure was associated with long-term impact on the cardiovascular system and regulation-Review. Acta Paediatrica, 110(9), 2536–2544. https://doi.org/10.1111/apa.15914

7. Avşar, T. S., McLeod, H., & Jackson, L. (2021). Health outcomes of smoking during pregnancy and the postpartum period: an umbrella review. BMC Pregnancy and Childbirth, 21(1), 254. https://doi.org/10.1186/s12884-021-03729-1

8. Chahal, N., McLain, A. C., Ghassabian, A., Michels, K. A., Bell, E. M., Lawrence, D. A., & Yeung, E. H. (2017). Maternal Smoking and Newborn Cytokine and Immunoglobulin Levels. Nicotine & Tobacco Research, 19(7), 789–796. https://doi.org/10.1093/ntr/ntw324

9. World Health Organization. Tobacco and stunting (WHO tobacco knowledge summaries). https://www.who.int/publications/i/item/9789240112025

10. Reeves, S., & Bernstein, I. (2008). Effects of maternal tobacco-smoke exposure on fetal growth and neonatal size. Expert Review of Obstetrics & Gynecology, 3(6), 719–730. https://doi.org/10.1586/17474108.3.6.719

11. Institute of Medicine. (2001). Reproductive and developmental effects. In K. Stratton, P. Shetty, R. Wallace, & S. Bondurant (Eds.), Clearing the Smoke: Assessing the science base for tobacco harm reduction (pp. 543–559). National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK222383/

12. Sun, J., Liu, X., Zhao, M., Magnussen, C. G., & Xi, B. (2023). Dose–response association between maternal smoking during pregnancy and the risk of infant death: A nationwide, population-based, retrospective cohort study. eClinicalMedicine, 57, 101858. https://doi.org/10.1016/j.eclinm.2023.101858

13. Shenassa, E. D., & Brown, M. J. (2004). Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics, 114(4), e497–e505. https://doi.org/10.1542/peds.2004-1036

14. Peng, Y., Tun, H. M., Ng, S. C., Wai, H. K. F., Zhang, X., Parks, J., … Kozyrskyj, A. L. (2024). Maternal smoking during pregnancy increases the risk of gut microbiome-associated childhood overweight and obesity. Gut Microbes, 16(1). https://doi.org/10.1080/19490976.2024.2323234

15. Health Canada. (2023). Second‑hand smoke. Government of Canada. https://www.canada.ca/en/health-canada/services/health-concerns/tobacco/legislation/tobacco-product-labelling/second-hand-smoke.html

16. Drehmer, J. E., Walters, B. H., Nabi-Burza, E., & Winickoff, J. P. (2017). Guidance for the Clinical Management of Thirdhand Smoke Exposure in the Child Health Care Setting. Journal of Clinical Outcomes Management, 24(12), 551–559.

17. Rissanen, I., Paananen, M., Harju, T., Miettunen, J., & Oura, P. (2021). Maternal smoking trajectory during pregnancy predicts offspring’s smoking and substance use – The Northern Finland birth cohort 1966 study. Preventive Medicine Reports, 23, 101467. https://doi.org/10.1016/j.pmedr.2021.101467

18. Hickson, C., Lewis, S., Campbell, K. A., Cooper, S., Berlin, I., Claire, R., Oncken, C., Coleman-Haynes, T., & Coleman, T. (2019). Comparison of nicotine exposure during pregnancy when smoking and abstinent with nicotine replacement therapy: systematic review and meta-analysis. Addiction,114(3), 406–424. https://doi.org/10.1111/add.14473