The Effects of Smoking and Substance Use During Pregnancy: Risks and Treatment Options

ichhori team

Smoking and drugs during pregnancy harm both mother and baby. Here's what really happens—and how to get help.

You’re pregnant. You’re stressed. Maybe you’re still smoking. Maybe it’s more than that.

Here’s the truth most people won’t say out loud:

If you keep smoking or using during pregnancy, your baby pays the price. Not in years — right now.

Let’s break this down without sugarcoating anything. You’ll learn what really happens to your body and your baby when you smoke, drink, or use drugs while pregnant. Then we’ll get into what actually works when you’re trying to quit — even if it feels impossible.

What Happens When You Smoke During Pregnancy?

The second you light up, nicotine and carbon monoxide are going straight through the placenta to your baby. That blocks oxygen. No oxygen = bad news.

  • Baby might come early
  • Baby might be underweight
  • Baby might die from SIDS (sudden infant death)
  • Baby might struggle with breathing, ADHD, or learning issues

And yeah — stillbirth becomes more likely.

You might think vaping is safer. It’s not. Same nicotine. Same outcome.

What About Alcohol or Drugs?

A glass of wine? A little weed? Pills?

Your baby feels it all.

  • Neonatal Abstinence Syndrome (NAS): full-on withdrawal after birth
  • Birth defects
  • Brain damage
  • Behavioural issues as they grow up
  • Miscarriage or stillbirth

You can’t “time it right” or “wait until the second trimester.” There’s no safe window.

Secondhand Smoke Isn’t Safe Either

Don’t smoke? Good. But if your partner or roommate does, you’re still at risk.

  • Trigger preterm labour
  • Lower your baby’s birth weight
  • Mess with brain development

The Baby Doesn’t Forget

Most people think once the baby is born, it’s over.

Wrong.

  • Developmental delays
  • ADHD
  • Learning problems
  • Anxiety
  • Aggression
  • Trouble sleeping

Babies who go through withdrawal cry differently. They scream. Their bodies shake. They have trouble eating. They don’t sleep.

This is called Neonatal Abstinence Syndrome (NAS) — and it’s rising fast. Especially in places with high opioid use.

So... What Can You Do?

Here’s what actually works. You don’t need to do all of them at once — but doing nothing isn’t an option.

1. Counselling (CBT or behavioural therapy)

If you’re hooked on nicotine, alcohol, or drugs — your brain is wired that way. Therapy helps rewire it.

Learn more about mental health and pregnancy

2. Nicotine Replacement (Patch, Gum, Lozenge)

Better than smoking. Not perfect.

If you're using these with medical supervision, they can help cut the cravings while doing less damage than cigarettes.

3. Medications for Opioid Addiction

Methadone or buprenorphine are game changers. They won’t get you high. They’ll stop the withdrawal and help your baby avoid NAS.

4. Pregnancy-Specific Rehab

There are programs just for pregnant women. These places know what you’re facing — physically, emotionally, everything.

See treatment programs for women

5. Group Support (NA, AA, Mom-Specific Meetups)

Other pregnant women are going through this too. You’re not the only one. Support groups reduce shame — and relapse.

You Can Turn This Around — Right Now

Most women don’t plan to use during pregnancy. Life happens. Stress, trauma, partners who use — it piles up.

But the second you decide to stop, things can get better.

Even quitting halfway through pregnancy lowers the risks. It’s not all or nothing.

Get help. Let your doctor in on it. Use the right support. Don’t white-knuckle this alone.

FAQs

Is it safe to vape while pregnant?

No. Vapes contain nicotine and other harmful chemicals. The risks are the same.

Can I drink a small amount of alcohol?

No amount of alcohol is safe during pregnancy. Period.

What if I used drugs before I knew I was pregnant?

Tell your doctor. They won’t judge you — they’ll help reduce the risks moving forward.

What’s NAS and why does it matter?

NAS = withdrawal in newborns. It’s painful, dangerous, and leads to long-term problems.

Is it too late to quit?

It’s never too late. Even cutting back now helps your baby.

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