Ask the Doctors: Pregnant woman must quit smoking for health of baby

Dear Doctor: Our daughter-in-law is four months pregnant with our first grandchild. When she and our son were recently visiting for the weekend, we became aware that she’s secretly smoking. She says it’s OK because it’s just three cigarettes a day and asked us not to tell our son. Is she correct? Two future grandparents are very worried.

Dear Reader: First, congratulations on your first grandchild! Let’s forget for the moment that your daughter-in-law is hiding important news from her husband (that’s a topic for another advice column) and get right to your question: No, it’s not OK to smoke while pregnant. In our opinion, no one should smoke at all. Ever.

Let’s start with some hard facts to share with your daughter-in-law regarding her own health and her cigarette habit:

— Smoking causes lung disease, including emphysema, chronic bronchitis and COPD.

— Smoking is the leading cause of most lung cancers.

— Smoking is a significant risk factor for many cancers, including colon, bladder, liver and blood cancers.

— People who smoke have two to four times the risk for heart disease and stroke than non-smokers.

— Even just a few daily cigarettes can cause symptoms associated with cardiovascular disease.

And it’s not just nicotine, carbon monoxide and tar that are a problem. The tobacco in cigarettes is treated with dangerous chemicals to affect taste and make it burn evenly. Superheat those chemicals and draw them into your lungs, and you’re playing chicken with a host of toxins.

To quote the Centers for Disease Control and Prevention, an agency not given to alarmist sentiments, “Cigarette smoking harms nearly every organ of the body, causes many diseases and reduces the health of smokers in general.”

Now that the basics are out of the way, let’s get specific about what happens when pregnant women smoke:

— Smokers have an increased risk of miscarriage.

—Babies born to smokers have a lower birth weight. And while having a smaller baby doesn’t sound that bad, low birth weight is a predictor of infant mortality.

— When a pregnant woman smokes, she puts her placenta, the unborn baby’s source of nutrition and oxygen, at risk. Smoking can cause the placenta to separate from the uterus too early. Known as placental abruption, this can prevent the baby from getting adequate oxygen and food. It can result in bleeding, which is a danger to both mother and baby.

— Babies whose mothers smoke during and even after pregnancy are at elevated risk of Sudden Infant Death Syndrome, also known as SIDS.

— Research shows that babies born to smokers have a slightly elevated risk of certain birth defects, like a cleft lip or cleft palate.

And now for the good news — it’s never too late to quit. We recommend that your son’s wife come clean about her habit to her OB-GYN. The fact that she has been smoking is information that her doctor needs in order to provide the best care. Also, her doctor can help her craft a plan to quit.

If she insists on going solo, there’s a host of resources via cdc.gov or 1-800-QUIT-NOW (1-800-784-8669).

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.