2004 Surgeon General's Report Highlights: Smoking Among Adults in the United States

Reproductive Health



  • Smoking harms many aspects and every phase of reproduction. Despite having greater increased knowledge of the adverse health effects of smoking during pregnancy, many pregnant women and girls continue to smoke (estimates range from 12% to 22%). It is estimated that only 18% to 25% quit smoking once they become pregnant. (p. 527)
  • Women who smoke are at an increased risk for infertility. Studies have shown that smoking makes it more difficult for women to become pregnant. (p. 534)
  • Research also has shown that smoking during pregnancy causes health problems for both mothers and babies, such as pregnancy complications, premature birth, low-birth-weight infants, stillbirth, and infant death. Low birth weight is a leading cause of infant deaths, resulting in more than 300,000 deaths annually in the United States. (p. 555, Ventura et al. 2000)
  • Once pregnant, women who smoke are about twice as likely to experience complications such as placenta previa, a condition where the placenta grows too close to the opening of the uterus. This condition frequently leads to delivery by a Caesarean section. (p. 551)
  • Pregnant women who smoke also are more likely to have placental abruption, where the placenta prematurely separates from the wall of the uterus. This can lead to preterm delivery, stillbirth, or early infant death. Estimates for risk of placental abruption among smokers range from 1.4 to 2.4 times that of nonsmokers. (p. 554)
  • Pregnant smokers also are at a higher risk for premature rupture of membranes before labor begins. This makes it more likely that a smoker will carry her baby for a shorter than normal gestation period. (p. 554)
  • Risk for having a baby in the smallest 5% to 10% of birth weights is as high as 2.5 times greater for pregnant smokers. (p. 574)
  • For reasons that are currently unknown, smokers are less likely to have preeclampsia, a condition that results in high blood pressure and an excess of protein in the urine. (p. 554)


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