# Help to stop smoking in pregnancy Intervention · id `maternal:smoking-cessation-in-pregnancy` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Preconception; Pregnancy Browse, care area: Routine pregnancy care ## In plain language Pregnant people can be asked about tobacco, advised to stop and offered counseling and other behavioral support to quit. US guidance (USPSTF, 2021) recommends this for pregnant people who use tobacco and grades it A. For medicines to help with quitting, the task force said the evidence in pregnancy is too thin to judge the balance of benefits and harms. Smoking in pregnancy can raise the risk of problems such as miscarriage and birth defects, and of complications for the child such as sudden infant death syndrome. ## Technical summary USPSTF 2021 covers adults 18 years or older, including pregnant persons, and treats pregnant persons separately. For pregnant persons it recommends asking about tobacco use, advising them to stop and providing behavioral interventions, with high certainty of substantial net benefit on perinatal outcomes and smoking cessation (an A recommendation). Pharmacotherapy in pregnancy is an I statement. The same statement also has an I statement on e-cigarettes in adults including pregnant persons, not recorded as a claim here. The abstract gives no effect sizes for pregnancy. ## Claims, with the population each applies to ## Context: Pregnant persons who use tobacco (USPSTF 2021) Recipient: Maternal; Population: Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.; Care setting: Primary care (the review evaluated primary care interventions).; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) ### The USPSTF recommends that clinicians ask all pregnant persons about tobacco use, advise them to stop using tobacco, and provide behavioral interventions for cessation to pregnant persons who use tobacco. It grades this an A recommendation and concludes with high certainty that the net benefit of behavioral interventions for tobacco smoking cessation on perinatal outcomes and smoking cessation in pregnant persons is substantial. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Maternal; Population: Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.; Care setting: Primary care (the review evaluated primary care interventions).; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Limitations: The PubMed abstract prints each grade after its statement, so the A for the pregnancy statement appears at the start of the next sentence. The same statement covers all adults 18 years or older, including pregnant persons; this claim is about the pregnancy part only. The abstract gives no benefit numbers for pregnant persons. USPSTF certainty levels are the task force’s own wording and not a GRADE rating, so certainty is not assessed. - Last checked: 2026-10-14 - Sources: 1. Supports: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, RECOMMENDATIONS, sentence 2. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: PubMed abstract of the USPSTF 2021 statement. 2. Supports: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, RECOMMENDATIONS, sentence 3. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: PubMed abstract of the USPSTF 2021 statement. 3. Supports: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, EVIDENCE ASSESSMENT, sentence 2. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: PubMed abstract of the USPSTF 2021 statement. 4. Background: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, POPULATION, sentence 1. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: Population, objective and background on harms of smoking in pregnancy. 5. Background: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, OBJECTIVE, sentence 1. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: Population, objective and background on harms of smoking in pregnancy. 6. Background: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, IMPORTANCE, sentence 3. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: Population, objective and background on harms of smoking in pregnancy. ### The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of pharmacotherapy interventions for tobacco cessation in pregnant persons, because few studies are available. It labels this an I statement. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Maternal; Population: Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.; Care setting: Primary care (the review evaluated primary care interventions).; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Limitations: An I statement is a statement about the evidence, not a recommendation against medicines. The same USPSTF statement also concludes that the evidence on e-cigarettes for smoking cessation in adults, including pregnant persons, is insufficient (an I statement); that is outside this claim’s population. The PubMed abstract prints each grade after its statement, so the I for the pharmacotherapy statement appears at the start of the next sentence. - Last checked: 2026-10-14 - Sources: 1. Supports: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, EVIDENCE ASSESSMENT, sentence 3. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: PubMed abstract of the USPSTF 2021 statement. 2. Supports: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, RECOMMENDATIONS, sentence 3. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: PubMed abstract of the USPSTF 2021 statement. 3. Supports: Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, fetched 2026-10-14. The full text and the version of record were not fetched.) Locator: Abstract, RECOMMENDATIONS, sentence 4. Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: 3745ae7e6024e6141d1bea59b2cb79113d2dd865c5a2531fb9276a0e08f8a558. How it applies: PubMed abstract of the USPSTF 2021 statement. ## Guidance, authorization and access ### Recommendation `maternal:rec-uspstf-2021-tobacco-behavioral-pregnancy` - Intervention: Help to stop smoking in pregnancy (`maternal:smoking-cessation-in-pregnancy`) - Direction: Recommended - Issued by: U.S. Preventive Services Task Force (`core:uspstf`) - Guideline record: USPSTF 2021: interventions for tobacco smoking cessation in adults, including pregnant persons (`maternal:guideline-uspstf-2021-tobacco-cessation`) - Guideline: Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions (USPSTF final recommendation statement page), edition Final recommendation statement page as fetched on 2026-10-14 (mx-uspstf-tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions.html). The date under the title is January 19, 2021.; snapshot `maternal:uspstf-tobacco-cessation-2021-2026-10-14` - Jurisdictions: United States; note: United States (the issuer is a United States task force). - Strength: A recommendation (USPSTF letter grades: A, B, C and D recommendations, and the I statement for when the evidence is insufficient to recommend for or against. The grade reflects the Task Force's certainty about net benefit. These are not GRADE strength labels.) - Effective: 2021-01-19 (The date under the title of the USPSTF final recommendation statement page, January 19, 2021. The statement was also published in JAMA, which has its own issue date.) - Supersession: Not checked - Applies to: Recipient: Maternal; Population: Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.; Care setting: Primary care (the review evaluated primary care interventions).; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Basis: claim `maternal:claim-uspstf-2021-tobacco-behavioral-interventions-pregnancy` ### Recommendation `maternal:rec-uspstf-2021-tobacco-pharmacotherapy-pregnancy` - Intervention: Help to stop smoking in pregnancy (`maternal:smoking-cessation-in-pregnancy`) - Direction: Evidence is insufficient to recommend for or against - Issued by: U.S. Preventive Services Task Force (`core:uspstf`) - Guideline record: USPSTF 2021: interventions for tobacco smoking cessation in adults, including pregnant persons (`maternal:guideline-uspstf-2021-tobacco-cessation`) - Guideline: Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions (USPSTF final recommendation statement page), edition Final recommendation statement page as fetched on 2026-10-14 (mx-uspstf-tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions.html). The date under the title is January 19, 2021.; snapshot `maternal:uspstf-tobacco-cessation-2021-2026-10-14` - Jurisdictions: United States; note: United States (the issuer is a United States task force). - Strength: I statement (USPSTF letter grades: A, B, C and D recommendations, and the I statement for when the evidence is insufficient to recommend for or against. The grade reflects the Task Force's certainty about net benefit. These are not GRADE strength labels.) - Effective: 2021-01-19 (The date under the title of the USPSTF final recommendation statement page, January 19, 2021. The statement was also published in JAMA, which has its own issue date.) - Supersession: Not checked - Applies to: Recipient: Maternal; Population: Pregnant persons who use tobacco. The USPSTF statement applies to adults 18 years or older, including pregnant persons.; Care setting: Primary care (the review evaluated primary care interventions).; Geography: United States (statement of the US Preventive Services Task Force); the abstract names no country.; Life stage: Pregnancy; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Basis: claim `maternal:claim-uspstf-2021-tobacco-pharmacotherapy-pregnancy-insufficient` ## Connected pages - The shared tobacco smoking page: Tobacco smoking (`core:tobacco-smoking`) - Filed under this front: Prevention and nutrition (`maternal:front-prevention-and-nutrition`) - USPSTF 2021: ask about tobacco, advise to stop and provide behavioral interventions for pregnant persons who use tobacco (A recommendation): Antenatal (prenatal) care (`maternal:antenatal-care`) [a claim, not a settled fact; see claim `maternal:claim-uspstf-2021-tobacco-behavioral-interventions-pregnancy` and its context] ## Provenance Content hash: 161dacc3490c322d7bab5bff6a35e5db21bb7abb3684d7f6480146b43aefb37b Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14