Dear Doctor,

I am a smoker and have never really thought about quitting. I just found out I am pregnant and I would like advise on how to stop. What can you recommend as this is not going to be an easy journey for me?

 Doreen

Dear Doreen,

Smoking is an unhealthy habit that affects virtually every part of the body negatively. It is hazardous during pregnancy as it can harm the pregnant mother as well as the baby in the womb.

In early pregnancy, smoking can cause miscarriage. If the pregnancy continues, there is a high risk of intra uterine death or stillbirth. Baby born may be born underweight. It can die early within few weeks. Also there is risk of her being born with congenital abnormalities or birth defects.

Smoking during pregnancy increases risk of hypertension and heart diseases in the woman, which is unsafe for pregnancy as well. There is increased vulnerability to develop lung infections.

It is not only active smoking, but even passive exposure to smoke, that can cause these problems.

Hence, best option is to quit smoking, even while planning to conceive. If not done at that time, it should be done within few weeks of becoming pregnant.

It is difficult to quit smoking if one has been doing it for a long time regularly and is addicted to it. But with some corrective measures and determination, it can be done.

The first thing which can be tried is a change in timetable. At the fixed time of smoking, an individual can try to go for a walk, start doing some work around the office or home, i.e. any activity to distract the mind from desire to smoke.

Some healthy and nutritious snacks like nuts or fresh fruit juice, and et cetera, consumed at that time can help in curbing the desire to smoke. It is also beneficial to learn techniques to relax like yoga and meditation. Because, stress itself is a risk factor pushing one to smoke in many persons.

Counselling by professional, taken either individually or as part of group, is very useful in helping one to quit. In group counselling, smoking addicts get to discuss their problems regarding this addiction and share experiences about measures to quit. This helps many persons in quitting smoking.

Nicotine replacement therapy is a medically approved way of helping tobacco addicts to quit smoking. Here, in place of cigarettes, nicotine is offered in different forms like nasal spray, skin patches, among other things. This should be considered as last measure to be adopted, if others fail.

Some women consider that smoking few cigarettes, say once or twice a week is okay. But this is wrong. Smoking occasionally, gradually leads to addiction and then one finds it difficult to quit. A woman should discard this habit as soon as possible, particularly if pregnant. Also, people around her should be advised not to smoke in her presence.

Dr. Rachna   Pande is a specialist in internal medicine.