A healthier start for you and your baby
A Time of Change
Pregnancy is a time of change. From now until the birth of your baby, your body will change each day. Not only will you look different, the way you think and feel about yourself may also change. This is especially true if you're pregnant and you smoke. If you've read the Surgeon General's warning labels about smoking, you know smoking is not good for you or your baby. But you may not know how to stop. The following text can help. It will give you skills that can help you gain control. With these skills, you can make a change in your life.
You Can Do It
You may have just learned you are pregnant, or you may be months along. Either way, it's not too late to make a change. Every cigarette you don't smoke is a benefit to you and your baby. Deciding not to smoke can be a tough choice, but you can change. Your reasons for not smoking may not be the same as those of a friend or family member. But the skills needed to stop smoking are shared by all. That's why this booklet's step-by-step process can work for you.
A Step-by-Step Process
There's the baby to plan for, changes in your family and plenty to do around the house or at work. Just the thought of quitting smoking may seem like more than you can handle. But have you really weighed the issues? Your actions can affect another life now. Would you try to quit if you had a step-by-step guide? No matter how you feel about smoking, take the time to read this guide. The skills you'll learn can help you during pregnancy and labour - even through the rest of your life.
How Do You Feel About Smoking?
Like most mothers, you want what's best for your baby. This is likely to include quitting smoking. Are you ready to quit? Only you can decide. People often make a change by moving through stages. Which of the women below is closest to how you feel right now? Depending on the stage you're in, you may need to work through sections of the text more than once. Do what's right for you. That way, you're working toward a change you can live with.
I'm Not Sure I Want to Quit
Why should I quit? I know women smokers who have healthy kids. Besides, my husband and mother-in-law smoke. Even if I quit, there'd still be smokers in the house. The baby and I would be breathing their smoke anyway. I did quit once, but I started again. It's just too much trouble to stop. I'm a smoker. Maybe that's all there is to it.
I'm Thinking About Quitting
Some days I'm sure I want to stop smoking, but I don't do it. There's always the cigarette that I really crave. You know, the one right after dinner or with coffee. I believe what I hear abut the benefits of quitting. Now that the baby's coming, I'm starting to think it would be good for us both. I might quit for may baby even though I wouldn't quit for myself.
I'm Ready to Quit
I'm taking action. I've cut down on the number of cigarettes I smoke. I keep saying I'm going to quit, but I can't always beat the urge to smoke. I light up, then I feel guilty. Sometimes I feel a little sick. Smoking isn't fun anymore. I'm trying to figure out why I still do it. How do I stop smoking? I need help to quit.
I'm Working to Stay Smoke-Free
I quit. I don't smoke anymore. I'm proud of myself, but I miss it sometimes. The withdrawal wasn't too bad. I was cranky for a few days. It takes work to quit at first. You have to find other things to do when you're tense. But I've made it this far, and I'm going to stay smoke-free. I think of myself in new ways, and I like it.
It's Risky Not to Know
Health studies have shown that smoking can affect your heart as well as your lungs. Smoking also raises your risk of certain cancers. These are all good reasons to quit. But they are reasons that affect you alone. While you are pregnant, smoking also can affect your unborn child and the pregnancy itself.
How Smoking Affects Pregnancy
Smoking during pregnancy reduces oxygen and blood flow to your baby. This may cause bleeding problems that can put your pregnancy at risk. In extreme cases, a pregnancy may end in miscarriage or stillbirth.
How Smoking Affects You
Smoking has been linked with many serious illnesses. It also has been shown to increase signs of ageing. A few of the health effects of smoking are listed below. Smoking can:
Increase your risk for lung cancer, bladder cancer and cervical cancer.
Raise blood pressure, which increases your risk of heart attack or stroke.
Reduce blood flow, which can slow healing and cause wrinkles.
How Smoking Affects Your Baby
When you smoke during pregnancy, you put your baby's health at risk. Any or all of the problems below are more likely to occur.
Your baby is more likely to be born too soon (premature birth). When this happens, the baby's lungs and other organs may not be fully formed.
Recent studies suggest that your baby might run a greater risk of sudden infant death syndrome (SIDS).
Your baby could have a low weight at birth. This does not make delivering the baby easier. In fact, a low-birth-weight baby is at greater risk during labour.
Smoking during pregnancy may be linked with childhood behaviour problems and slower progress during the early years of school.
Your baby could have breathing problems, such as asthma or allergies.
If you smoke and breastfeed, chemicals in the cigarettes can be passed to the baby through your breast milk.
While you're pregnant, you are breathing for two - for you and your baby. When you smoke, your breathing becomes shallow and your lungs fill with smoke. This means you and your baby get less air. Cigarettes also fill your body with chemicals, such as nicotine and tar. These get passed on to your baby.
Smoke. Cigarette smoke contains carbon monoxide. This gas takes the place of oxygen in your blood. It is passed to your baby through the bloodstream.
Nicotine. This drug raises your blood pressure and heart rate. It reduces blood flow to your arms and legs and slows digestion. Nicotine may also reduce blood flow to your baby.
Tar. Tar is what's left after tobacco is smoked. This sticky brown material gums up your lungs, so less oxygen gets into your bloodstream. This affects you and your baby.
Are You Thinking About Quitting?
"I have a friend who smoked through both her pregnancies and her babies were fine. Why should I worry about smoking?"
"My sister smoked through her last pregnancy, and her daughter was born early. Tanya was so tiny, they kept her in the hospital for weeks."
"When I quit, I had to ask my husband not to smoke around me. It was the only way I could give up cigarettes."
"I've cut down, but my husband still smokes. Maybe I should ask him to smoke on the balcony."
Even if you're not sure you want to quit smoking, be sure you understand your choice.
Have you ever thought about not smoking? Or are you already trying to smoke less?
Are you ready to take action?
Have you already stopped smoking?
If you have, good for you! Use the following activities to help you stay quit.
How Do You Benefit by Quitting?
You and your baby both benefit when you quit smoking. Think about it. You're likely to find many benefits to quitting. Take your life span, for example. Most people who quit smoking have less illness and live longer. Can you think of any more reasons to quit?
How Your Baby Benefits
Think about your baby. What are your hopes for your child? Perhaps the money that used to go for cigarettes could be saved for baby clothes, music lessons or college.
How You Benefit
Think about your life. What's important to you? Most people who quit smoking find their health gets better and they have a little extra money to spend.
Learn Why You Smoke
For most smokers, cigarettes fill a need. You may feel that smoking gives you energy. Perhaps it's a pleasure, or simply a habit. You may like to touch and handle cigarettes. If you learn the reasons why you smoke, you can find other ways to meet your needs. For instance, if you smoke to reduce stress, try deep breathing instead. When you have other things to do, it's easier to quit.
List Your Reasons. You're likely to have a few reasons why you smoke. Most smokers do. Maybe you smoke to keep your hands busy. Think about your reasons and list them.
Find Other Things to Do. What can you do instead of smoking? Keep your hands busy by doodling or stringing beads. List new activities.
Deep Breathing: Breathe Air Instead of Smoke
Deep breathing fills your body with oxygen. This relaxes muscles and helps relieve tension. Instead of smoking, use the steps shown here to cope with stress. Try it for a couple of days. You may find that deep breathing is a fast, easy and healthy way to control stress.
Step 1: Sit or lie down with your knees bent a little. Put your hands on your stomach. Inhale through your nose. Feel as if you are breathing into your stomach.
Step 2: Slowly exhale all the air through your mouth. Feel the air travel up and out of your body. Repeat this at least 4 times.
Getting Ready to Quit
"You know, I'm really thinking about quitting smoking. But I'm going to need a plan. I can't just tough it out."
"Ask your family to help. My wife and I quit before the first grandchild came. We stopped so our son and his wife would have an easier time quitting."
"You know it's the best thing to do for you and the baby. Those warning labels are on cigarettes for a reason."
Changing how you feel about yourself is the first step. Before you can quit, you have to want to quit.
Is it time for you to get ready to quit smoking?
If so, read on. You'll find out how much you want each cigarette, as well as specific times and places that tempt you to smoke.
Are you still unsure about whether or not to quit?
Even if you're not sure about quitting, try using the smoking diary. You'll learn even more about when and why you smoke.
Have you already stopped smoking?
Knowing your smoking triggers can help you avoid a slip.
When Do You Smoke?
Like any habit, smoking may be something you do without thinking. Try being more aware. Take a few days - including one weekend day - and write down each time you smoke a cigarette. Use a diary to record what you are doing and feeling when you light up.
Your Smoking Diary
Who are you with? What are you doing when you light that cigarette? Rate how badly you want to smoke (Number 1 is a little; number 2 is more; number 3 is a lot).
Review your notes after a few days. How does this diary compare with your list of reasons why you smoke?
What Triggers You to Smoke?
Look at your smoking diary again. For each entry, try to figure out what triggered your urge to smoke. A smoking trigger may be a feeling or a person. It may be a place or an event. Triggers are personal. Your triggers may not be the same as those of a family member or friend.
I.D. Your Triggers
You can plan ways to avoid your smoking triggers once you know what they are. Triggers can be physical. For example, you may feel restless after sitting through a meeting or a movie. Emotions can also be triggers. You may smoke when you feel angry, tired, lonely or bored. List your triggers.
"I still miss that after-dinner cigarette. So I'm going to watch the news while you finish up."
"No problem. I'll join you after my smoke."
Let Go of Stress Without Smoking
Stress is a common way to react to life events. Your body may become tense or your mood may shift. You may feel a vague sense of worry. Stress is one of the biggest reasons people smoke. But you can let go of stress without lighting up. Do something else instead. Learn to relax. Pull up a picture in your mind. Exercise or lighten your outlook. The urge to smoke often passes in 3 to 5 minutes.
Learn to Relax
This simple process helps get the kinks out of your body. The basic idea is to tighten and release your muscles. With practice, you can relax anywhere, anytime you feel tense. Repeat the steps below with all your major muscle groups from head to toe.
1. Get ready. Set aside 15 to 20 minutes in a quiet place. Sit or lie down so you feel at ease. Loosen any tight clothing. Take off your shoes and glasses, if you wear them.
2. Focus your mind. Pick any part of your body. Your right hand might be easiest to start with. Close your eyes and see your hand in your mind.
3. Tighten your muscles. Close your right hand into a fist. Really clench those muscles for 10 to 15 seconds. Tighten your muscles enough to cause them to shake a tiny bit.
4. Let go and relax. Release the fist. Let go of the muscles and feel the tension melt away. Your muscles should feel heavy and warm - soft like melting butter.
Pull Up a Picture
Everyone needs to get away once in a while. If you can pull up a pleasant image, you can escape at will. Whether you're waiting for the laundry to finish or taking a short break, the steps below can work.
Sit or lie down so you feel at ease. Close your eyes, and take a few deep breaths.
Bring a picture, word, or thought to mind. Hold it there. If you choose a place, try to hear, feel and smell it.
Other thoughts may enter your mind. Let them pass by like clouds moving gently overhead.
When you're done, breathe deeply and gently open your eyes.
Add a few active minutes to your day. Using your lungs more may make you want to smoke less. Besides, even mild exercise clears the mind, burns calories and tones muscle. In fact, the more fit you are during pregnancy, the easier your recovery is likely to be after the birth. Get your health care provider's okay before trying the tips below.
Park away from the building and walk.
Stroll around the block.
Use the stairs.
Take an exercise or stretching class designed for pregnant women. Or try an entry-level yoga class.
Lighten Your Outlook
Certain feelings can trigger a strong urge to smoke. Try the tips below when you need to lighten your outlook on life.
If you're bored, get active. What needs to be done before the baby is born? Pick a name. Find a crib.
If you're tired, take a nap. Eat a healthy snack, such as low-fat yoghurt or fruit. Put your feet up and rest.
If you're angry, count to 50. Then deal with the cause of the anger.
If you're frustrated, take a 10-minute time-out. Write down the problem, or talk it over with your partner or a friend.
If you're worried or afraid, sing out loud.
Are You Ready to Take Action?
"The pregnancy is fine so far, but your smoking concerns me. I'd like you to quit. But if you're not ready, how about cutting the number of cigarettes you smoke by half? Try to do this by your next visit."
"My doctor says I have to stop smoking. I'm cutting down and planning to quit. Can you spend some extra time with me during the next few weeks? It would help me get past the hardest part."
The way you feel about smoking may change after talking with your doctor or feeling your baby move. What you do about such a change is up to you.
Now that you've thought about quitting, are you ready to do it?
If you're ready to take action, keep reading and make a plan.
Are you still thinking about quitting?
Even if you're not ready to quit, learn to set limits. Try making a "limit list."
Are you having trouble staying quit?
Try finding support and staying on track.
Plan to Quit Smoking
Having a plan helps you reach any goal. Your plan to quit smoking starts with a choice. First, you have to pick a way to quit. Just remember: Both ways of quitting require you to stop at some point. Pick the method that suits you best. Then set a quit date and some smoking limits.
Pick a Way to Quit
You can stop smoking in either of the two ways listed below.
Cold turkey: Today you smoke, tomorrow you don't. This is rough at first, but change takes place quickly and withdrawal may be shorter.
Tapering off: Over time, reduce the number of cigarettes you smoke each day. To do so, increase the amount of time between each smoke. Try not to inhale more deeply or take more puffs.
Set a Quit Date
No matter which method you choose, pick a date to quit smoking entirely. Choose a date within the next 2 to 4 weeks if you're serious about quitting. After picking a day, mark it in bright, bold letters on a calendar you use often.
Whether you decide to quit cold turkey or to taper off, setting limits can help you quit. Start by limiting where you can smoke. Pick one room or a porch, and smoke only in that place. This will put a little distance between you and the habit. Make smoking outdoors a house rule, and other smokers won't tempt you as much. Also, hang your list of quit benefits in the spot where you smoke. Put a copy on the refrigerator, and stick one on the dashboard of your car.
Your Limit List
What can you do to limit your smoking? Start by giving up number 1 cigarettes (the ones you want the least). Use your diary to remind you which ones these are. Write down a few more ideas.
Find Support and Make a Contract
"I'm planning to quit smoking. Can I count on your support? Maybe we could have lunch on the day I quit."
Don't go it alone. Making a change is always easier if you have support. Ask your partner or a friend to share in your progress. Also, do your best to deal with doubters. If you explain why this change is important to you and your baby, taking action will be easier. To make sure you stick to your quit plan, make a contract and put it in writing.
Ask for Help
Asking for help means you're strong enough to make this change. Start by telling one or two people that you are quitting. Ask them to help you stick with it. Can you call them when the urge to smoke is strong? Who do you know who doesn't smoke? Can you spend free time with this person?
Deal with Doubters
Friends or family members who smoke may not support your desire to quit. They may feel bad about their own smoking. Or they may be afraid you will reject them if they don't quit, too. Instead of being angry or hurt, explain how quitting is best for you and the baby. Send a letter or use the phone if this is too hard to do in person.
Make a Contract
A quit-smoking contract gives you a goal. Write out the contract and sign it. Have it witnessed, if you like. Make your own contract. Then tape the contract where you'll see it often, or carry it with you. Read the contract when you're tempted to smoke.
Stick to Your Quit Date
When your quit day arrives, stick to the plan. Stop smoking. Don't delay. Now is the time to keep moving forward. Reread your contract, and review the benefits you gain by quitting. Tell yourself that you can do it. Then quit. Every time you think about smoking, say, "Good for me! I quit. I don't do that anymore."
On the Day You Quit
Get off to a clean, fresh start. Use the tips below to start this day off right.
Clean cigarettes out of your purse, kitchen drawer, glove compartment, pockets and any other place where you stashed them.
Throw away all smoking materials. Bury, burn or "drown" cigarettes and matches if you feel it would help.
Wear a light spray of perfume, and count the number of people who say how good you smell.
Set a time to have your teeth cleaned.
Stock Up for Survival
Pack a few items to get you through your first non-smoking day. Instead of cigarettes, keep these on hand:
Sugarless gum and mints or carrot sticks to keep your mouth busy.
Toothpicks, straws or paper clips to hold.
Coloured pens or pencils to doodle with.
A string of beads to play with.
You say you feel jittery. You can't sleep. In fact, you can't even stand to wait for a movie or a bus! Life may seem out of control, but you're really making progress. These new traits are all symptoms of withdrawal, your body's way of recovering from smoking. If you cough, remind yourself that your lungs are clearing. Use the Four D's listed below when you need to beat withdrawal.
Withdrawal Doesn't Last Long
As the nicotine leaves your body, you're likely to notice symptoms of withdrawal. Symptoms may start within the first 24 hours after you quit smoking. For some people, withdrawal is mild. Others have a harder time coping with the way they feel. In any case, withdrawal should begin to lessen after the first few days.
Common Symptoms of Withdrawal
Some of the most common withdrawal symptoms are:
Feeling cranky and restless
Having trouble sleeping
Feeling low on energy
Use the Four D's
Withdrawal symptoms and smoking urges are strongest the first few days. Know that the cigarettes you rated as number 3 in your diary will be the hardest to give up. Use the Four D's below to help you cope when you crave a smoke:
Deep-breathe. This calms the urge to smoke.
Drink water. This will keep your hands and mouth busy.
Do something. File your nails. Learn a nursery rhyme. Count how many people are dressed in red.
Delay! Put off smoking. The urge to smoke lasts only 3 to 5 minutes.
Keeping on Track
"I didn't think I wanted to quit. But when I looked at it, I found more reasons not to smoke than to smoke."
"Chewing carrot sticks helps cut my urge to smoke."
"I can tell the baby I quit smoking for him. I can say, 'Mommy loved you enough to do what was best.'"
"I don't take cigarette breaks anymore, Anne. I've stopped smoking. How about joining me for a walk instead?"
Whether you've quit or cut back on your smoking, reward yourself for making a change.
How do you feel about smoking now?
Which woman is closest to where you are now?
Have you taken any steps towards change?
Are you still getting ready to quit smoking?
Add to your list of other things to do.
Try to give up your number 1 and 2 cigarettes. Use your diary to remind yourself of these.
Are you planning to stay quit after your baby is born?
Learn how to avoid being tempted.
Stay Positive, Stay on Track
Three cheers for you! If you haven't had a smoke in 48 hours, you're well on your way to beating withdrawal. If you're smoke-free for 7 days, you're likely to have a quit for good. Even if you're still tapering off, enjoy your success. Tell your supporters, and be good to yourself. You deserve it. Rewards have many forms. Find the ones that are special to you.
Hear Your "Self-Talk"
All of us have a voice inside. Think of it as a background "tape." It tells you how you see yourself and the world. What's running on your tape? Listen for your inner voice. It's easiest to hear at night when everything is quiet. It also shows up when you mutter out loud.
Tape a New Message
Positive self-talk can help you stay on track. If you hear yourself being negative, put the thought on hold. Rewind and erase the tape. Then form a new message with a positive twist, like this: "Congratulations! Look how far you've come."
You've taken control and made change work for you. In doing so, you've also done something good for your baby. This is a big deal. Don't wait. Reward yourself now. Spend time with a friend who doesn't smoke. Have your hair done. Buy new earrings. Use the money you've saved by not smoking cigarettes. Just be careful if food is your fondest reward. Low-fat choices are the best way to prevent gaining weight.
My Best Rewards
List the rewards that have meaning for you. A reward could be something you want but don't need.
Take Care of Yourself
Be good to your body. Eat right and snack smart. Sleep when you need it. A nap can help lighten your mood. Besides, you'll be less tempted to smoke if you feel good. Also, take any prenatal vitamins, as prescribed. If you feel low on energy, they may give you a healthy boost. If you're worried about your weight, talk with your health care provider.
Food is fuel for you and the baby, so make all of your calories count. Avoid the empty calories and excess salt in fast food and junk food. Instead, eat from all the food groups. Here are a few of the best choices:
Leafy green vegetables
Lean meat, fish
Low-fat cheese and low-fat milk
Don't starve yourself. Eat if you're hungry between meals. Just be sure to choose healthy snacks. Here are a few:
Low-fat yoghurt and low-fat ice cream
Herbal or decaffeinated tea
Rest isn't a luxury. You need sleep now more than ever, so the growing baby won't wear you out. There are no "normal" sleep schedules. Just do your best to sleep when you're tired. Nap when you can.
Plan to Stay Quit
At first, not smoking will be new and exciting. It is change of the best sort. People will congratulate you. Enjoy it. You have a right to be proud. But what about later? How do you stay quit when life goes back to a more normal routine? Plan ahead to resist temptation. Also, be aware of signs that might warn of a slip.
Prepare to be Tempted
It will happen. You'll be tempted. Tough times are still ahead. Get ready to resist your number 3 cigarettes. You know the big triggers: car trips, holiday meals, family visits, a chat with a friend who still smokes. Also, beware of your number 1 and 2 cigarettes. The tips below can help you resist.
Talk to your baby.
Make your home a "Smoke-Free Zone."
Make a list of all the things you can smell, taste and do better since you quit smoking.
Pack a survival kit to take in the car.
Heed Warning Signs
Do you daydream about smoking? Do you put yourself in high-risk places, such as having lunch with a group of smokers? Such acts signal danger. They could be a warning that you're headed for a slip. If you think you might smoke again, ask yourself why. What are the times and the reasons you feel this way?
HALT Your Desire
HALT your desire to smoke. Keep yourself from feeling too Hungry, Angry, Lonely or Tired. Replace your sense of need with a positive act. Reward yourself. Fix a great meal. Get the baby an early present.
If You Slip
If you do slip, it's not the end of your quit process. Whether you sneak or smoke or boldly inhale, tell yourself you're no longer a smoker. A slip is not a relapse. Don't let your success go up in smoke. Find out why you lit up. Then make a new plan to strengthen your success.
Find Out Why
A slip can be useful. If you're honest, this action might tell you something. Do your best to answer these questions:
Did you learn anything new about smoking?
How did the cigarette taste?
How did your hands smell after you smoked?
What did you learn about being tempted?
Have you found a new trigger?
What can you do to avoid slips in the future?
Make Your Success Stronger
Now get busy and build on your early success. List how you benefit by staying quit. Your lists, like your life, are likely to change. This is part of finding out who you are. Do you remember how smoking can affect your baby? "Is smoking my friend or is my baby my friend?"
Staying Quit After Your Baby is Born
Oh, baby! You've both come a long way. Think of your newborn's first cry, that new-baby scent. Use the excitement and newness of it all to help you stay quit. The benefits of not smoking will last your whole life. But change related to the birth may trigger an old urge to smoke. Make a new plan. Use all of your new skills to get through these busy months.
The Benefits Last a Lifetime
You quit smoking so you'd have a healthier baby. Now stay quit, so you'll be a better role model. By not smoking, you'll also gain the big benefits listed below:
Healthier breast milk
Less chance of sudden infant death syndrome (SIDS)
Fewer coughs and colds for you and your child
Less risk of your child having allergies, asthma or other lung problems
Less chance that your child will smoke
A greater chance of having a long and healthy life to spend together
Having Problems Staying Quit?
What if you can't quit all the way or you start smoking again? Many people quit more than once before stopping for good. Success is a building process. You can improve with practice. Work through this programme again. Also talk with your health care provider about joining a support group or seeing a counsellor. And remember: Every cigarette not smoked benefits baby and you.
Make a New Plan
You're likely to have a few crazy months ahead. You'll be taking care of a new-born. And if that's not enough, you may be running a house - and maybe going back to work, too. Plan ways to take care of yourself, so you won't be tempted to smoke.
Get some exercise. Also do the deep-breathing exercise.
Take another look at your list of triggers. Add any new ones that may show up.
Review how to let go of stress without smoking.
Rest when the baby sleeps, and know when to say no visitors. Set limits. It's okay to protect your family.
Use Your New Skills
The skills presented here can help you make any change. Put them to use. As a parent, you'll need to know yourself. This should be clearer now that you've faced your triggers and beaten the smoking habit. Take a minute to list all that you've overcome since you started to quit smoking.