A reduction in tobacco use increases birth weight, decreases the incidence of low birth weight infants and is cost effective. Cognitive ability is marginally improved in children of mothers who have not smoked during gestation. Further evaluative research is needed on interventions designed to maintain abstinence. Burden of Suffering Smoking during pregnancy harms both the mother and her developing fetus. Aside from increased morbidity and mortality from cancers, cardiovascular and pulmonary disease in the mother, smoking has been implicated in the etiology of abruptio placenta, placenta previa, spontaneous abortion, premature delivery, and stillbirth.
Cigarette smoking is the principal cause of low birth weight in developed countries.
Intrauterine growth retardation is the most strongly documented adverse effect of smoking during pregnancy. This is a significant public health concern because low birth weight is the most important single determinant of neonatal and infant morbidity and mortality. Retarded fetal growth in the offspring of smokers may be attributable to several factors, including the vasoconstricting properties of nicotine, elevated fetal carboxyhemoglobin and catecholamine levels, fetal tissue hypoxia, reduced delivery of nutritional elements and elevation of heart rate and blood pressure. Even after controlling for alcohol use, socioeconomic status, maternal height, maternal weight and years of education, smoking has been implicated in long-term effects such as poor cognitive performance on achievement tests and decreased physical growth. Most of this decline in low birth weight has been attributed to a decrease in smoking rates in women of reproductive age.