7 August 2019

Is it important to quit smoking during preconception?

By the Editorial Comitee IVI Blog

Is it important to quit smoking during preconception?

Preconception is the period of time when you prepare to start trying for a baby. In medical circles there is a growing recognition that maternal health before conception, not only during pregnancy, can have a major effect on the development and prospects of the unborn child. The best-known example of this is the now widely known development in spina bifida prevention. We now know that a small amount of the B-vitamin folic acid can reduce neural tube defects by up to 70%. This clinches the case for pre-conception health having a direct impact on the unborn child. But what about smoking? In this article we take a look at the benefits of quitting smoking before pregnancy. We also examine the potential damage it can do, some aspects of which you may not be aware.


Does smoking reduce fertility?

The very idea of preconception assumes that you are fertileto become pregnant. In fact, there is a lot of evidence that smoking reduces fertility, thus reducing your chances of getting to that stage. Our IVI Malaga Director, Dr. Anabel Salazar, confirms this in a recent Q & A session. Some of the health hazards of smoking are very well known, but surprisingly few people are aware that damage to your reproductive system is one of them. One US survey estimated that fewer than 25% of women knew that smoking could damage their fertility or raise their risk of having a miscarriage.

These are some of the ways that smoking before pregnancy can harm both you and your future child:

  • Smoking can cause changes to the cervix and heighten the risk of cervical cancer;
  • It can cause damage to developing eggs in the ovaries;
  • It can lead to harmful changes in uterine lining, which may mean that healthy implantation by an embryo is less likely;
  • The toxins contained in cigarettes may damage the DNA of your eggs, increasing the likelihood of producing abnormal embryos (aneuploidy)
  • Smoking agents or metabolites have an influence on fallopian tube function (which are responsible for gamete and embryo transportation), contributing to female infertility and ectopic gestation
  • Premature aging of the ovaries and a resulting decrease in the number of eggs could result in premature menopause, up to four years earlier than normal;
  • It can cause poorer embryo development and reduced implantation rates
  • Smoking before pregnancy increases the risk of miscarriage, probably due to endometrial effect and increased risk of aneuploidies

Another very significant reason to quit smoking before getting pregnant is to reduce the baby’s risk of birth defects. The risks of smoking during early pregnancy are well known, but many birth defects occur in the very early days, which could be before you are even aware that you have conceived. This is more evidence to show that it’s best not to wait until you become pregnant to reduce the risk of harm to your child.


What about vaping and other nicotine substitutes?

E-cigarettes deliver nicotine without producing two of the main poisons found in cigarettes: tar and carbon monoxide. However, they are not risk-free; the vapour does contain some of the same harmful chemicals as cigarettes, but in much lower quantities.  

Other nicotine replacement options come in the form of patches, gum, lozenges and microtabs, inhalers and nasal sprays. All of these are better than continuing to smoke, as long as you remember that the use of patches should be restricted to 16 hours in a 24-hour period, easily achievable if they are removed at night.

All these options might be an option to help you quit smoking. Nonetheless, vaping and other options mentioned should be also avoided If you’re interested in reading more about quitting, why not have a look at our blog article on World No Smoking Day?

How else can I improve my health during preconception?

Quitting smoking as part of your preconception preparations is undoubtedly important, but there are other health-related measures you can take. These include:

  • Reduce alcohol intake and avoid the use of recreational drugs, as well as taking care over any potential hazards of prescription drugs. Some authorities also advise a reduction in caffeine intake.
  • Get plenty of sleep – eight hours is ideal for optimum health and can also help to reduce tension.
  • Get used to tracking your periods and menstrual cycle so that you are familiar with your normal rhythms.
  • Eat a healthy diet, including the all-important folic acid supplements, to maintain a healthy weight. Your preconception nutrition is not only important for the health of your child, but for your own health.
  • Exercise within reason. Walking and cycling, aerobics and swimming, are all beneficial. Yoga is also a great choice as it includes breathing and concentration techniques which could be helpful during labour. For more tips, see our blog article on exercise during pregnancy.

Our conclusion? The same as yours!

Obviously, it is extremely important to quit smoking during preconception. As a final thought, of course we recognise that the process of quitting may be difficult, but it will be more difficult if you leave it until later when you are dealing with all of the pressures, anxieties and joys of impending parenthood.

A further consideration is that, because of the addictive nature of nicotine, you have to ask yourself: if not now, when? When you are in your third trimester and your habit is reducing vital oxygen and nutrients to a rapidly developing foetus? When your baby is born prematurely or underweight, about eight ounces lighter than it would be otherwise and is more prone to infection? Or when your child is a baby or toddler and growing up in a smoking household with an increased risk of illnesses like asthma? 

It hardly bears thinking about does it?

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