Smoking in pregnancy and covid-19

Coronavirus and smoking in pregnancy

This page contains resources and information on coronavirus (COVID-19) for maternity professionals working to reduce smoking in pregnancy. It will be updated regularly with new resources and information as the situation develops.

Key points

There’s never been a more important time to support smokers to quit. All pregnant smokers must continue to be given evidence based support to quit.

Whilst CO monitoring should be paused during this period as a precautionary measure, NHS England still recommends that all women are asked about their smoking status at antenatal appointments, and time of delivery, and given appropriate advice and support.

Opt-out referral pathways to specialist support should also remain in place.

CO monitoring should be re-introduced as soon as the COVID-19 situation has resolved to a background risk.

COVID-19 and smoking in pregnancy

As a precautionary measure, the government has classed pregnant women as a group at risk of severe illness with COVID-19. 

COVID-19 is a respiratory infection which can cause life threatening systemic inflammation and pulmonary and cardiovascular complications.

Public Health England guidance states that: “On the available evidence, we advise:

  • if you smoke, you generally have an increased risk of contracting respiratory infection and of more severe symptoms once infected. COVID-19 symptoms may, therefore, be more severe if you smoke.
  • stopping smoking will bring immediate benefits to your health, including if you have an existing smoking-related disease. This is particularly important for both you and for our NHS at a time of intense pressure on the health service.”

The evidence is clear that:

This is significant health information, which smokers have a right to know, and they need to be supported to take steps to quit or abstain from smoking. See our FAQs for more information on COVID-19 and smoking.

Secondhand smoke

People, including children, exposed to secondhand smoke are also at increased risk from coronavirus. It is therefore essential that parents, carers and other household members are advised not to smoke in the home or around pregnant women and children. They should be provided with behavioural support and access to alternative nicotine products (including NRT or e-cigarettes) to enable this.

Supporting pregnant smokers to quit during the COVID-19 pandemic

  • CO monitoring has paused as per NHS guidance.
  • However, the rest of the pathway including opt-out support must remain in place. The Standard Treatment Programme for Pregnant Women can still be used, minus CO monitoring.
  • While face-to-face stop smoking services are not operating, consultations are being provided remotely via telephone, video conferencing etc and it’s vital this support remains in place.
  • Women must still be able to access NRT.

See full NHSE Guidance for details.

E-cigarettes and vaping

E-cigarettes are the most popular aid to quitting smoking in England. Whilst not completely risk free, switching completely to vaping is significantly less harmful than continuing to smoke.

The priority is to be smokefree. If vaping is helping pregnant women to manage nicotine withdrawal and stay smokefree, they should be reassured that it is much less harmful to themselves and their baby than smoking, and they should continue to vape.

For people who don’t smoke or have never smoked, the advice is don’t start vaping as it is not risk free.

For more information see the Smoking in Pregnancy Challenge Group resources on vaping in pregnancy.

See also: RCM Position Statement on Nicotine in Pregnancy

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