How tobacco affects babies and children

When pregnant women use tobacco

What happens to your baby when you use tobacco

  • Your baby gets less oxygen and food because nicotine from cigarettes tightens up your blood vessels.
  • Your baby gets less oxygen when carbon monoxide, a poisonous gas from cigarettes, gets into your bloodstream. Carbon monoxide can also cause your baby to grow less and reduce your baby's brain weight.
  • Some of the harmful gases and poisons from cigarettes get into your baby's bloodstream.

Smoking increases the possibility of:

  • miscarriage or stillbirth
  • infection in your uterus
  • postpartum depression
  • high blood pressure caused by the pregnancy
  • premature birth (smoking doubles the chance a baby will be born before 37 weeks)
  • a low birth weight baby (less than 5 ½ pounds). Small babies are often sick with many health problems. They are more likely to need special care and stay in the hospital longer. Smoking doubles the chance of a low birth weight baby.
  • death by sudden infant death syndrome (SIDS). Low birth weight babies are 40 times more likely to die in the first month than normal weight babies.
  • birth defects such as cleft palate or cleft lip
  • placenta previa (when the placenta forms at the cervix), which increases your chance of bleeding during pregnancy or needing a Cesarean birth. It also can increase the risk of death for both you and your baby.
  • the placenta separating from the uterine wall, causing bleeding
  • may cause childhood behavior problems
  • can damage your baby's developing brain
  • problems with how well your baby's lungs work and develop

When mothers who use tobacco breastfeed

Your baby gets more nicotine from your breast milk than you receive from smoking. It is best to not smoke until your child is weaned from breastfeeding.

When parents and other adults smoke around babies and children

  • Cigarette smoke contains more than 7,000 chemicals. More than 70 can cause cancer.
    • Poisonous gases and chemicals in secondhand smoke include hydrogen cyanide (used in chemical weapons), carbon monoxide (in car exhaust), butane (used in lighter fluid), ammonia, and toluene (found in paint thinners).
    • Toxic metals in secondhand smoke include arsenic (used in pesticides), lead, chromium (used to make steel) and cadmium (used to make batteries).
  • Secondhand smoke can cause cancer, heart disease and respiratory problems later in life.

Secondhand smoke is a mixture of smoke coming from the burning tips of cigarettes, pipes and cigars, and smoke exhaled by people who smoke.

Someone who does not smoke and is around secondhand smoke breathes in the chemicals from the tobacco smoke.


Quitting tobacco is the only way to lower your chances of risks and problems listed above. Cutting down on the number of cigarettes you smoke will not lower your risks.

Secondhand smoke can be harmful to children

  • Breathing in cigarette smoke causes a child's airway to get smaller, making it hard to breathe. Secondhand smoke:
    • causes between 150,000 to 300,000 lower respiratory tract infections (such as bronchitis and pneumonia) in children younger than 18 months old
    • can cause asthma, trigger asthma attacks and make asthma attacks worse
    • can cause children who develop asthma to spend more time in the hospital than those who develop it from other reasons
    • causes coughing and breathlessness
  • Secondhand smoke puts children at an increased risk for ear infections and the need to have ear tubes.
  • Secondhand smoke can cause tooth decay in children. Research has shown that nicotine promotes the growth of the bacteria that causes tooth decay. Young children who are around secondhand smoke have a higher risk of tooth decay than children who live with those who do not smoke.
  • Secondhand smoke after delivery can also raise the chances of children dying from SIDS.


The more a child is exposed to secondhand smoke, the more health risks he or she faces.

Children of parents who use tobacco are more likely to:

  • have an increased risk of heart disease
  • have ear infections and colds
  • develop chest illnesses such as bronchitis and pneumonia
  • have asthma, wheezing and other lung issues
  • be overweight or obese
  • have higher blood pressure
  • have an increased risk of allergies
  • have lower control of blood glucose
  • use tobacco and become addicted to tobacco more quickly


No amount of secondhand smoke is safe. Rolling down the windows in your car or opening windows in your home does not reduce secondhand smoke.

Thirdhand smoke is real

Thirdhand smoke is the chemical residue left from secondhand smoke.

It is what you smell on your clothes, hair, furniture or in the car. Thirdhand smoke is also the brown film on walls. The residue can cling to surfaces for months. The particles are very tiny and can easily get into your lungs when you breathe.

Smoking near an open window, blowing smoke out of a room with a fan, using an air filter, or smoking outside does not prevent secondhand and thirdhand smoke.

Thirdhand smoke is known to trigger asthma attacks and other health problems. It may cause cancer.

Small children spend much of their time on floors and exploring their world with their hands and mouths. Chemicals (including nicotine) from tobacco smoke cling to the surfaces children explore such as toys and floors. This means they are touching and putting these chemicals in their mouths.

If you or someone in your house continues to smoke, smoke outside. Use a smoking jacket, tie up your hair, or wear a hat that you can take off before you have contact with your child. Never leave your child alone in your house while you are outside.


Chemicals from tobacco smoke cling to the surfaces children explore such as toys and floors.

How to protect your child(ren)

On average, children are exposed to more secondhand smoke than nonsmoking adults. No amount of secondhand smoke is safe.

The only way to protect your family from secondhand smoke is to live in 100 percent smoke-free environments. You can help protect your family.

  • Make your home and car smoke-free.
  • Ask people not to smoke around you and your child(ren).
  • Check on the smoking policies of unlicensed daycare providers and other caregivers.
  • Share information with other parents about the health risks of secondhand smoke.
  • Teach your child(ren) to stay away from tobacco products and secondhand smoke (in public and at friends' or relatives' houses).

Quitting smoking will put stress on your baby.

The risks to your baby if you continue smoking are far greater than if you quit.


Electronic cigarettes (e-cigarettes or e-cigs), JUUL®, hookah pens, vapes, vaporizers, vape pens, e-hookah, e-pens, e-pipes and e-cigars are all known as electronic nicotine delivery system (ENDS).

E-cigarettes have become very popular very quickly. This means there has not been time to get results from long-term studies on the safety or health effects of e-cigarettes.

  • A 2018 public health research report supported by the U.S. Food and Drug Administration confirms that using ENDS products is harmful. Use causes health and safety problems and greatly increases tobacco addiction among adolescents.
  • The name of the report is "Public Health Consequences of E-cigarettes" by the National Academies of Science, Engineering, Medicine (NASEM).
  • The FDA has not approved e-cigarettes as a way to quit smoking. According to the 2018 NASEM report, there is "limited" evidence that e-cigarettes help some people to quit smoking. Many people return to smoking, continue to use the e-cigarette, or use both. None of these options are healthful.


Electronic nicotine delivery systems cause health and safety problems. Dangerous and harmful chemicals have been found in secondhand vape.

How to quit tobacco

The best way to protect the health of your family is to quit using tobacco. This can be one of the most important things you do to help the health of you and your child during and after your pregnancy.

It can be difficult to quit during pregnancy. Hormones, stress, fear and anxiety can keep you from reaching your goal. It can also be difficult to quit if your partner uses tobacco as well.

Quitting can be done and you and your baby can have the best chance of living a healthy life!

One of the best things you can do is to find as much support as possible. The more support you have, the more successful you can be. It also helps you stay quit after your baby is born. Here are a few ways to get support:

  • Talk with your health care provider.
    • Ask if medicine can help you quit.
    • Ask if nicotine replacement therapy is right for you. Short-acting ways (gum or lozenge) are preferred when you are pregnant.
    • Ask about the benefits and risks of using nicotine replacement therapy if you are breastfeeding.
    • Call the tobacco hotline numbers to talk with a trained tobacco counselor.
    • Ask for the Allina Health "Tobacco Intervention Program" booklet. It talks about services, triggers, medicines and other methods of quitting.
      • If your provider does not have this, call the tobacco hotline numbers for Allina Health: 612-863-1648 or 763-236-8008 to receive a booklet by mail.
  • Mental health conditions can increase your triggers to use tobacco. If you have a mental health condition, talk with your primary care provider. Quitting tobacco does not make mental health conditions worse.
  • Talk with your partner or other members of your care circle (family members or friends). If any of them use tobacco, ask them to quit or keep all tobacco use outside.
  • Ask for encouragement from members of your care circle when you quit. Kind words, trust and support in doing activities which do not trigger tobacco use can be helpful.

    If you feel like you are not getting the right support, you have the right to ask for kind words, trust and encouragement. Tell people what you need. Shaming, blaming and negativity is not the right type of support.
  • Call the Livewell Fitness Center at 612-863-5178 to make an appointment with a coach. A trained tobacco counselor will meet with you over the phone or in person to help you reach your goals.
  • Call your insurance provider. Many companies have tobacco programs that can help you quit.


To help you quit, think about ways to spend the money you were spending on tobacco. Plan your baby's nursery space or room. Go for a walk with a friend who does not use tobacco.

If any adult in your home smokes and is not ready to quit, only allow smoking outside.

Tips to help you quit

  • Quitting tobacco is not always about success or failure. Think of it as "practice." You are practicing living your life without tobacco.
  • Each time you make an effort to not smoke or use any tobacco products during a craving, you will discover ways that do and do not help. This will lead to a life without tobacco.
  • It may feel awkward at first and it may take up some of your energy. However, the more purposeful you are about discovering what your life can be like without tobacco, the higher the chance you have of staying quit.
  • You may be able to quit "cold turkey" (stopping all use of tobacco products suddenly without medicine). To help:
    • Think about ways you can spend the money that you were spending on tobacco.
    • Focus on doing other things that bring you pleasure, such as going for a walk, spending time with a friend or making plans for your newborn.


One of the best things you can do to help you quit is find as much support as possible. The more support you have, the more successful you can be. This is good for you and your baby!

Staying quit

It is important to talk with your primary care provider soon after pregnancy. Remind him or her about your efforts to quit tobacco and ask for his or her continued support.

You may need to learn new skills in dealing with your emotions and managing stress. Being open to trying new methods can be helpful if you need this. Besides talking with your primary care provider, you may consider seeing a counselor or talking to a wellness coach.

Be a role model

Three out of four people who use tobacco have a parent who uses tobacco. Babies and children spend a lot of time watching their parents. You can be a powerful role model for your child(ren) by not using tobacco. For example, you can teach them positive ways of dealing with stress.

Quitting for your baby does not actually stop after delivery. Your baby will be exposed to secondhand and thirdhand smoke every time you hold and feed him or her.


Help your baby learn positive lifelong habits—like how to deal with stress—by not exposing him or her to tobacco and tobacco smoke.

Allina Health resources for quitting

  • Tobacco Intervention Program at Abbott Northwestern Hospital: 
  • Tobacco Intervention Program at Mercy Hospital: 
  • Tobacco Intervention Program at River Falls Area Hospital:
  • *Allina Health United Lung and Sleep Clinic Tobacco Cessation Program: 
  • *Penny George™ Institute for Health and Healing (LiveWell Center) tobacco intervention coaching:  

*There may be a cost to you. Check with your insurance provider.



You can do this! Quitting tobacco is a great way to take care of your health and your baby's health.

Related resources

Source: Allina Health's Patient Education Department, How Tobacco Affects Babies and Children, gen-ah-28651 (10/18)
First Published: 10/04/2002
Last Reviewed: 10/15/2018

Not ready to quit? Consider taking a break!

If quitting tobacco seems like too much right now, consider taking a break or a vacation from tobacco use.

This can help you feel better by restoring balance*.

  • Set a goal to stop using tobacco.
  • Talk with your doctor for resources or ways to cope with withdrawal symptoms.

If this goes well, maybe you will take more breaks during the year. This could lead to a tobacco-free life!

*Follow your doctor’s directions for medicine, exercise, diet and other activities.