Academic journal article Journal of Prenatal & Perinatal Psychology & Health

Tobacco Abuse in Pregnancy

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

Tobacco Abuse in Pregnancy

Article excerpt

ABSTRACT: Nicotine Tobacum with its 4,000 additives remains the most injurious addiction to the pregnant woman and her baby. At the discovery of being pregnant 60% of women will quit and 40% will continue throughout the pregnancy. For those 40% tobacco's chemicals will be absorbed into mother's blood, and the baby will be bathed in these toxins. There will be 144,000 spontaneous abortions (approximately 14.6% of all pregnancies), a weight deficit of almost one pound, a loss of 50 I.Q. points in the baby, and affective disorders programmed in the innocent fetus. This article reviews the evidence-based literature regarding findings about tobacco's products and their effect on gestation.

KEY WORDS: Tobacco abuse, pregnancy, spontaneous abortion, prematurity.


There are greater than 1.3 million people who quit smoking in the U.S. each year. That is a remarkable number attempting to reverse the tobacco damage to their health. Unfortunately 50 million continue this dangerous addiction. Of women who smoke, close to 60% percent stop smoking as soon as they find out they are pregnant. Sadly, that means that about 40% continue to abuse tobacco during this critical period.

With this percentage then, tobacco ranks as the most commonly abused drug in pregnant women. It is noted that there is an increasing number of women using smokeless tobacco as well (mostly in the Southeastern USA). Even more striking is the projection that between 200-300 million of the world's children will die of tobacco-related disease in their lives. There are estimated to be 1.1 billion people daily using tobacco worldwide (Rotarian, 1999, p. 12). According to the World Health Organization (WHO), 3.5 million people die each year as a result of tobacco abuse.

As an obstetrician, for a long time I have tried to discourage smoking during pregnancy. I have always counseled women in their pre-conceptional visits to stop tobacco use before they attempt to conceive. I warn those that are using no contraceptive or inadequate measures like diaphragms and condoms that they should stop tobacco so that the unborn child will not be bathed in all the tobacco chemicals ingested through their lungs and mucus membranes during that most vulnerable, formative time, the first 12 weeks of pregnancy. The early conceptus certainly does not need all the tobacco chemicals that are driven into the blood stream poisoning the new, developing child. There is no question, however, that I have made some patients angry and others have left my office feeling guilty. While it was not my intention to have them feel bad, I wanted them to be informed about the terrible consequences. I have probably gotten about the average number of women to stop the habit. Of those, I have never met a woman who was not completely thrilled to have quit both for herself and her baby. Their pride was worth the effort.

This paper is a review of the gathering literature on the subject of the effects of tobacco use and pregnancy. Through this medium I hope to bring an increased awareness of tobacco and its contribution to negative pregnancy outcomes. Much of the information about tobacco abuse is well known and denied by the tobacco companies and people who are addicted. I know, I denied physical damage in my own body for a long time before I quit. This article is written for those women who are pregnant or are contemplating pregnancy and for the professionals who work in childbirth.


Historical Background

The culture of tobacco began in the Western Hemisphere and was carried to other countries by mariners. Columbus is thought to have brought tobacco to Europe. North and South American Indians used raw tobacco for spiritual purposes. (This is a totally different product than the manufactured products we consume today.) Apparently, the early voyagers began its use in their travels. Nicotina tabacum (Gruenwald, Brendler, & Jaenicke, 1998) is grown for its leaves, which are known to contain 19 carcinogens. …

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