Smoking during pregnancy

Clinical commentary

Women who smoke tobacco during pregnancy are more likely to experience pre-term birth, placental complications and perinatal death of their baby (WHO 2013)

Babies of mothers who smoke during pregnancy are at increased risk of poor growth during pregnancy, particularly during the phase of rapid weight gain from 34 weeks gestation onwards (Sirvinskiene et al. 2016). Sudden infant death syndrome, childhood diabetes and childhood obesity have been linked with exposure to tobacco during fetal development (Banderali  et al. 2015; Flenady et al. 2018). Maternal smoking is associated with low birthweight, which in turn is linked with poor educational outcomes in early childhood, coronary heart disease, type 2 diabetes, and being overweight in adulthood (Guthridge et al. 2015; Lumley et al. 2009).

Smoking cessation during pregnancy is key in reducing the risk of complications during pregnancy and birth as well as reducing adverse health outcomes for the baby. Cessation at later stages of pregnancy will still improve health outcomes for the baby, including improved fetal growth (AIHW 2018; Miyazaki et al. 2015).

There are clear associations between smoking in pregnancy, age of the mother, remoteness of residence and disadvantage quintile evident in the results presented. Varying sociodemographic profiles of women who give birth in public and private hospitals needs to be taken into account when considering the higher rates of smoking in pregnancy for women giving birth in public hospitals.

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information, refer to Specifications and notes for analysis in the technical notes.


  • AIHW (Australian Institute of Health and Welfare) 2018. Perinatal deaths in Australia 2013–2014. Cat. No. PER 94. Canberra: AIHW.
  • Banderali G, Martelli A, Landi M, Moretti F, Betti F, Radaelli G, Lassandro C & Verduci E 2015. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. Journal of Translational Medicine 13:327.
  • Flenady V, Wojiezek AM & Middleton P 2018. Stillbirths: recall to action in high-income countries. Lancet 387(10019):691–702.
  • Guthridge S, Li L, Silburn S, Li SQ, McKenzie J & Lynch J 2015. Impact of perinatal health and socio-demographic factors on school education outcomes: A population study of Indigenous and non-Indigenous children in the Northern Territory. Journal of Paediatrics and Child Health 51(8):778–86.
  • Lumley J, Chamberlain C, Dowsell T, Oliver S, Oakley L & Watson L 2009. Interventions for promoting smoking cessation during pregnancy. Cochrane Database of Systematic Reviews (3):CDD001055.
  • Miyazaki Y, Hayashi K & Imazeki S 2015. Smoking cessation in pregnancy: psychosocial interventions and patient focused perspectives. International Journal of Women’s Health, 7:415–427.
  • Sirvinskiene G, Zemaitiene N, Jusiene R, Smigelskas K, Veryga A & Markuniene E 2016. Smoking during pregnancy in association with maternal emotional well-being. Medicina 52(2):132–138.
  • WHO (World Health Organization) 2013. Who recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. Viewed 14 June 2018.