Pregnant Smokers: A Critical Dilemma

Smoking during pregnancy doubles a woman’s risk of having a baby of low birth weight, less than than 5.5 pounds, according to the government’s annual report on the health effects of tobacco. Quitting is the best idea. Cutting back appears to have little or no impact on birth weight, according to the report.

However, a recent Oklahoma-based study, also funded by the government, found that reducing the number of cigarettes can help. Paying attention to diet can also help, according to the study.

But a Los Angeles expert says there is no substitute for quitting.

Quit!

William J. McCarthy, UCLA adjunct assistant professor of psychology and a smoking-cessation researcher: “It’s much better for pregnant women to quit smoking than to try to offset the negative effects of tobacco by food intake or other means.

“Smoking during pregnancy does not just affect the child’s birth weight. It can affect the child’s cognitive functioning, even at age 3, according to at least one study. Quitting during pregnancy is not impossible.

“One national study shows more than a third of pregnant women stop smoking spontaneously--most when they find out they are pregnant--either due to concern over the baby or because morning sickness makes smoking unpleasant.

“What works for the other two-thirds? Initially, willpower and knowledge about the benefits of quitting are important. In the long run, living in a smoke-free environment is most important.”

Decrease smoking and increase food intake.

Dr. Warren Crosby, professor of obstetrics and gynecology, University of Oklahoma Health Sciences Center, Oklahoma City: “If you’re pregnant and can’t quit, at least reduce the number of cigarettes to fewer than 10 per day. All smoking is bad, but the fewer the better.

“In our study (of nearly 400 pregnant women), those who smoked more than 10 cigarettes a day were more likely to give birth to low birth weight infants.

“If you can’t quit or cut down, switch to a lower-tar cigarette. Barring that, pregnant women smokers should focus on increasing their intake of food, particularly protein, as they continue to try to kick the habit.

“In our study, women smokers who increased protein and total calories had bigger babies--seven ounces larger on average--than pregnant women smokers who did not.