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“Tobacco smoke and its residues are among the most important toxic environmental exposures to children, linked to health concerns from behavior problems such as ADHD to sudden infant death. The smoke contains over 250 poisonous gases, chemicals, and metals including hydrogen cyanide, arsenic, butane, toluene, lead, cadmium, and pelonium-210. Eleven of the components are group 1 carcinogens – the most potent cancer-causing chemicals. There is no known safe level.”

– Dr. Alan Greene (2009, p. 126)

Smoking during pregnancy is one of the most harmful things you can do to your baby. In fact, smoking is the leading cause of preventable pregnancy complications, linked to increases in things like ectopic pregnancy, abnormal placental implantation, premature placental detachment, premature rupture of membranes, possible early delivery, and much more. Yet studies show that around 14% of women smoke throughout their pregnancy. (Berman, 6-1-2009) If you fall into this category, this chapter will explain what’s at risk and hopefully help you kick the habit for good.

How smoking during pregnancy affects your fetus

Smoking has a direct and near instantaneous effect on your developing baby. Studies have shown fetal heartbeats speed up whenever a mother smokes, and cigarette fumes have been found to have a near instantaneous effect on fetal blood flow. The fumes in cigarette smoke contain components that disrupt the placenta, depriving a child of oxygen and other important nutrients. Because of this disruption and insufficient oxygen, a baby can’t grow as well as they are meant to, resulting in everything from low birth weights to poorly formed organs. This is probably why, as Dr. Greene notes, “Babies have been seen on ultrasound to react with disgust to the smell of cigarette smoke.” (ibid, p. 63) And these are just the immediate effects of smoking. It doesn’t take into account all the long-term risks that come from exposure to a toxin such as cigarette smoke.

Different types of cigarette smoke to be wary of

You don’t have to be a smoker yourself to endanger your baby. There are three types of exposure, and all can be hazardous:

Firsthand smoke:
This comes from smoking tobacco products directly, and will obviously expose your unborn baby to the fullest effects.

Secondhand smoke:
Inhaling secondhand smoke can be just as bad as firsthand smoke in that it contains all the same nasty stuff, though the overall intake is going to be lower than puffing up directly, unless you’re in a confined room with a smoker. That said, researchers have found genetic alterations in those exposed to secondhand smoke that are similar to those seen in smokers themselves. (Park, 2010) So it’s something you should avoid as much as possible.

Third-hand smoke:
The dangers of third-hand smoke are well documented, yet I’d wager that if you stopped people on the street, few would even know precisely what it is. Smoking releases a variety of toxins which form a chemical residue that settles on surfaces and is then absorbed through the skin (or ingested and inhaled, such as when you touch a contaminated surface and then lick your fingers or rub your nose). The best way to think of it is to bring to mind the image of someone who’s had a house fire. The flames may engulf everything in a particular room, but the soot from this fire can cause just as big of a mess, coating everything in the house with a thin black tar. The exact same thing happens when it comes to cigarette use, only this residue is invisible. Just like the soot from a house fire, chemical residues float freely throughout the air before settling on whatever happens to be in their path – walls, furniture, car seats, floors, etc. If you had a special camera to see it, this toxic residue in a smoker’s room would coat everything in it just as thick. The walls, the carpet, the furniture; everything becomes coated with the toxins contained in that smoke.

Because of third-hand smoke, parents who smoke in the car or the garage or other areas children frequent aren’t actually sparing them from the effects of smoking just because the kids aren’t around at the time. If you then use that same car to shuttle them to soccer practice, they’re going to be poisoned from the chemical residue. While third-hand smoke doesn’t have the same immediate effects on a fetus in terms of choking its blood flow, the chemical exposure is nonetheless worrisome, and is linked to a number of health problems. (Winickoff et al., 2009)

This means its not just mom who should seriously consider quitting during pregnancy. Expectant fathers may want to kick the habit to protect the health and safety of their family.

What about e-cigarettes?

E-cigarettes have been touted as a safer alternative to traditional smoking by tobacco companies – a way to get the fix without actually smoking. Research casts serious doubt on these claims, and e-cigarettes still contain many (in fact most) of the same carcinogens (especially nicotine) found in regular cigarettes, just without the smoke. In fact, the few studies that are finally trickling out on these products suggest they may even be more potent and more addictive than traditional cigarettes, with a higher nicotine content. The vaping process may even result in smaller particles that are inhaled deeper into the lungs.

When history is finally written on the e-cigarette revolution, I think we’ll come to see it as the time when tobacco companies pulled a fast one over on both regulators and the general public. They’ve managed to replace a harmful product that was going out of style with a new harmful product that is marketed almost like a health food and becoming a new craze. Just as importantly, it seems to have been custom-designed to hook a new generation of kids. It’s a technological gadget (perfect for all the tech-prone kiddoes out there) and its vaping juices come in as many flavors as Baskin Robbins, with names like Bubblegum or Cool Mint. Unfortunately, by the time the research catches up and we begin to realize what these companies have done, a new generation will be hooked and the industry will be too entrenched to get rid of.

In the meantime, I think you need to approach e-cigarettes with the idea that they are just as harmful to your baby as the other kind. If your doctor thinks they would be a safer option then go ahead and follow his advice, but don’t assume these products are a safe alternative to quitting. The little independent research that’s been done has not been encouraging, and it’s way too early to tell whether they’ll even have a beneficial effect on rates of lung cancer, which is pretty much the only claim that might have merit. (Then again, we may find that vaping simply causes different types of lung problems.) But as of right now, the idea that e-cigarettes are a safer alternative to smoking is based on little more than the smoke cigarette companies are trying to blow up your butt.

What about other tobacco products?
All tobacco products contain nicotine, which is carcinogenic. Many of the chemicals in tobacco smoke also come from enhancements that tobacco companies have thrown in to make their product more addictive, and many of these same things are added to chew or other tobacco products. Whether these are any safer than smoking is an open question, but it’s not as though you bypass the chemical exposure simply by going to smokeless tobacco.

What about smoking before pregnancy?

Thankfully, there is no evidence that all the smoking you did prior to pregnancy has any effect on the baby. (Murkoff & Mazel, 2008) Most of the research suggests the most serious effects begin around the third month of gestation. So if you quit now, your baby will be spared the worst effects.

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