Smoking during Pregnancy


smoking, inhalation and exhalation of the fumes of burning tobacco in cigars and cigarettes and pipes. Some persons draw the smoke into their lungs; others do not. Smoking was probably first practiced by the indigenous peoples of the Western Hemisphere. Originally used in religious rituals, and in some instances for medicinal purposes, smoking and the use of tobacco became a widespread practice by the late 1500s. Tobacco was introduced into Europe by the explorers of the New World; however, many rulers prohibited its use and penalized offenders. By the end of the 19th cent. mass production of cigarettes had begun, and the smoking of cigarettes became prevalent as the use of cigars and pipes declined. Despite controversy as to the effects of smoking and bans on smoking by certain religious groups, the use of tobacco continued to increase.

Health Effects

Smoking is considered a health hazard because tobacco smoke contains nicotine, a poisonous alkaloid, and other harmful substances such as carbon monoxide, acrolein, ammonia, prussic acid, and a number of aldehydes and tars; in all tobacco contains some 4,000 chemicals. In 1964 definitive proof that cigarette smoking is a serious health hazard was contained in a report by the Surgeon General's Advisory Committee on Health, appointed by the U.S. Public Health Service. The committee drew evidence from numerous studies conducted over decades. They concluded that a smoker has a significantly greater chance of contracting lung cancer than a nonsmoker, the rate varying according to factors such as the number of cigarettes smoked per day, the number of years the subject smoked, and the time in the person's life when he or she began smoking. Cigarette smoking was also found to be an important cause of cancers of the esophagus, nasopharynx, mouth, larynx, kidney, and bladder as well as a cause of chronic obstructive pulmonary disease, emphysema, and heart disease, stroke, and other cardiovascular diseases. Since then it has been found to be an independent risk factor in male impotence. Smoking also increases risks associated with oral contraceptive use and exposure to occupational hazards, such as asbestos. Pipe and cigar smokers, if they do not inhale, are not as prone to lung cancer as cigarette smokers, but they are as likely to develop cancers of the mouth, larynx, and esophagus. Those who use snuff or chewing tobacco (sometimes called "smokeless tobacco" ) run a greater risk of developing cancer of the mouth.

Inhalation of tobacco smoke by nonsmokers has been found to increase the risk of heart disease and respiratory problems; this has created a movement for smokeless environments in public spaces, including government buildings, office buildings, and restaurants. Fetal damage can be caused if a mother smokes or is exposed to smoke during pregnancy. Children of smokers have a higher risk of asthma and lung disease.

Regulation of Tobacco and Smoking

Because of mounting evidence of health risks, television advertisements for cigarettes were banned beginning in 1971. In the 1980s, Congress began to require stronger warning labels on all print advertising; soon afterward it banned smoking on domestic air flights. Concerns about the effects of tobacco smoke on nonsmokers led government and businesses to place additional restrictions on smoking in public, common, and work areas; more than two thirds of U.S. states now place some restrictions on smoking in public places.

A 1988 report of the Surgeon General of the United States recognized nicotine as an addictive substance, leading the Food and Drug Administration (FDA) to consider treating nicotine as any other addictive drug and implementing stricter regulations. The authority of the FDA to regulate smoking was, however, denied by the Supreme Court. In 2009, however, the U.S. Congress passed legislation that allows the Food and Drug Administration to regulate cigarettes and other forms of tobacco; the law also imposed additional restrictions on the marketing of tobacco products. The habit of smoking continues to increase in the young despite the illegality of cigarette sales to those under 18 years of age in all 50 states.

The Framework Convention on Tobacco Control, a treaty adopted by World Health Organization members in 2003, seeks to reduce the number of tobacco-related illnesses and deaths by establishing international standards for antismoking measures; it entered into force in 2005. The convention restricts the marketing and sale of tobacco products and requires health warnings on packages of cigarettes. The treaty has been signed, but not ratified, by the United States. Indoor air quality laws, high taxes on tobacco, and measures against cigarette smuggling are encouraged under the pact.

Legal Battles

In the mid- and late 1990s the tobacco industry in the United States faced grave legal and financial threats. Under heavy attack from states seeking compensation to recover costs for smoking-related health care, from the federal government seeking further regulation, and from individual smokers seeking damages for illness, the major cigarette producers sought ways to protect themselves. After a tentative $368 billion settlement (1997) with state attorneys and plaintiffs' lawyers fell apart, lawsuits were brought against the industry by Florida, Minnesota, Mississippi, and Texas; the suits were settled for $40 billion, to be paid over 25 years. In 1998 the remaining 46 states accepted a $206 billion plan to settle lawsuits they had filed against the industry. Individual lawsuits continued to pose potential significant financial threats.


See publications of the Office on Smoking and Health of the Centers for Disease Control and publications of the American Cancer Society and the American Lung Association; see also E. C. Hammond, I. J. Selikoff, and J. Chung, "Asbestos exposure, cigarette smoking and death rates" from Annals of the New York Academy of Sciences (1979); R. J. Troyer and G. E. Markle, Cigarettes: The Battle over Smoking (1983); P. Taylor, The Smoke Ring (1984); Imperial Cancer Research Fund, World Health Organization, and American Cancer Society, Mortality from Smoking in Developed Countries 1950–2000 (1994); R. Kluger, Ashes to Ashes (1996); S. A. Glantz, J. Slade, L. A. Bero, P. Hanauer, D. E. Barnes, The Cigarette Papers (1996).

The Columbia Encyclopedia, 6th ed. Copyright© 2015, The Columbia University Press.

Smoking during Pregnancy: Selected full-text books and articles

Smoking, Drinking, and Drug Use in Young Adulthood: The Impacts of New Freedoms and New Responsibilities By Jerald G. Bachman; Katherine N. Wadsworth; Patrick M. O'Malley; Lloyd D. Johnston; John E. Schulenberg Lawrence Erlbaum Associates, 1997
Librarian’s tip: "Pregnancy and Parenthood Related to Cigarette Use" begins on p. 64
Helping the Hard-Core Smoker: A Clinician's Guide By Daniel F. Seidman; Lirio S. Covey Lawrence Erlbaum Associates, 1999
Librarian’s tip: "Smoking Cessation Approaches for Pregnant Women" begins on p. 76
Private Choices, Social Costs, and Public Policy: An Economic Analysis of Public Health Issues By Nancy Hammerle Praeger Publishers, 1992
Librarian’s tip: "Cigarette Smoking: Prevalence and Short-Term Consequences of Prenatal Smoking" begins on p. 140
Mother and Fetus: Changing Notions of Maternal Responsibility By Robert H. Blank Greenwood Press, 1992
Librarian’s tip: "Maternal Smoking" begins on p. 36
Essays on Women, Medicine and Health By Ann Oakley Edinburgh University Press, 1993
Librarian’s tip: "The Pregnant Smoker" begins on p. 100
Knowledge about the Deleterious Effects of Smoking and Its Relationship to Smoking Cessation among Pregnant Adolescents By Albrecht, Susan A.; Higgins, Linda W.; Lebow, Howard Adolescence, Vol. 35, No. 140, Winter 2000
Pregnant with Meaning: Teen Mothers and the Politics of Inclusive Schooling By Deirdre M. Kelly Peter Lang, 2000
Librarian’s tip: "Flash Point: The Case of Teen Mothers Who Smoke" begins on p. 40
The Exposure of Nonsmoking and Smoking Mothers to Environmental Tobacco Smoke during Different Gestational Phases and Fetal Growth. (Children's Health Articles) By Dejmek, Jan; Solansky, Ivo; Podrazilova, Katerina; Sram, Radim J Environmental Health Perspectives, Vol. 110, No. 6, June 2002
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Cord Serum Cotinine as a Biomarker of Fetal Exposure to Cigarette Smoke at the End of Pregnancy By Pichini, Simona; Basagana, Xavier; Pacifici, Roberta; Garcia, Oscar; Puig, Carmen; Vall, Oriol; Harris, Jessica; Zuccaro, Piergiorgio; Segura, Jordi; Sunyer, Jordi Environmental Health Perspectives, Vol. 108, No. 11, November 2000
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Birth Weight and Exposure to Kitchen Wood Smoke during Pregnancy in Rural Guatemala. (Children's Health Articles) By Boy, Erick; Bruce, Nigel; Delgado, Hernan Environmental Health Perspectives, Vol. 110, No. 1, January 2002
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Fetal Growth and Length of Gestation in Relation to Prenatal Exposure to Environmental Tobacco Smoke Assessed by Hair Nicotine Concentration By Jaakkola, Jouni J. K.; Jaakkola, Niina; Zahlsen, Kolbjorn Environmental Health Perspectives, Vol. 109, No. 6, June 2001
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
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