Smoking is the one of the most important modifiable causes of poor pregnancy outcomes in the United States, and is associated with maternal, fetal, and infant morbidity and mortality. This ACOG Committee Opinion provides evidence-based guidance on helping pregnant women quit smoking. It contains examples of effective smoking cessation interventions and instructions for use of the 5A’s, a counseling intervention specifically targeted to pregnant women. The potential effects on pregnancy and lactation of alternative forms of nicotine, such as e-cigarettes and vaping, as well as medications used to help with smoking cessation, are also discussed.
Evidence Rating: III