Smoking, drug and alcohol use and preconception health

Smoking

Substance use can have negative effects on preconception health as well as causing issues for parents and children.

Stopping smoking before conception is one of the best steps a parent can take to improve fertility and ensure a healthier pregnancy, reducing risks for both parent and baby.

Both partners should work together to quit smoking to improve their chances of conceiving.

Smoking during pregnancy increases the risk of stillbirth, miscarriage and sudden infant death.

Other health problems linked to smoking include:

• low birth weight (2 times more likely, average 30g to 40g lighter)
• heart defects (25% more likely)
• stillbirth (47% more likely)
• preterm birth (27% more likely)
• miscarriage (32% more likely)
• sudden infant death (3 times more likely)

Babies born to women and people who smoke are more likely to be underdeveloped and have poor health.

After birth, parental smoking is also linked to a higher risk of sudden infant death.

Smoking contributes to health inequalities, as there are higher smoking in pregnancy rates among teenagers and women in disadvantaged areas compared to those in wealthier groups.

Encouraging more women and pregnant people to have a smoke-free pregnancy and stay smoke-free after birth can reduce the risks of smoking-related complications for both the parent and baby.

Smoking before conception can harm fertility and negatively affect the health of a future pregnancy, posing risks for all genders of reproductive age.

Addressing smoking before conception is key to improving reproductive health and reducing pregnancy complications.

Even if the pregnant person does not smoke, exposure to second-hand smoke can still harm the pregnancy.

Tackling tobacco use before conception is crucial for better health outcomes for both the parent and their future children.

Creating a smoke-free environment at home is essential for maternal and fetal health, as well as reducing second-hand smoke exposure:

• always smoke outside
• ask visitors to smoke outside
• don't smoke in the car or let anyone else do so

Women and people trying to conceive should join smoking cessation programmes to improve their preconception health. Partners and supporters play an important role in this too.

Many healthcare providers offer resources and nicotine replacement therapy (NRT) to help people quit smoking before pregnancy.

Since 2015, it has been illegal to smoke in a car carrying anyone under 18.

Nicotine Replacement Therapy (NRT)

NRT is often recommended as a safer option to help women and people quit smoking before and during pregnancy, although its use before conception should also be considered carefully.

Pregnant women and people who are trying to quit should be supported with NRT to manage nicotine withdrawal and stay smoke-free.

Vaping or e-cigarettes

Vaping, or using e-cigarettes, has become a popular alternative for those trying to quit smoking traditional tobacco products.

E-cigarettes are generally seen as less harmful than regular cigarettes, but the evidence on their safety, especially before conception and during pregnancy, is still being researched.

Messages for professionals to share around smoking:

• encourage women and pregnant people to contact their GP or midwife as soon as they find out they are pregnant
• advise them to speak to their GP or local stop smoking service for help to quit smoking

More information on other websites

Derby residents can get free stop smoking support from Livewell or telephone: 01332 641254.

Action on Smoking and Health (ASH) is an independent public health charity set up by the Royal College of Physicians to end the harm caused by tobacco. You can also read about using e-cigarettes before, during and after pregnancy.

The National Smokefree Helpline can be contacted by telephone on 0300 123 1044.

Protecting a baby from tobacco smoke is one of the best things individuals can do to give their child a healthy start in life. It can be difficult to stop smoking, but it's never too late to quit. View the NHS website - Stop smoking in pregnancy.

Substance misuse

Non-prescription and recreational substance use can have serious, long-lasting effects on anyone person and if the person is pregnant, it can effect the developing baby.

Substance use can severely impact preconception health, fertility and pregnancy outcomes, posing risks to both the parents and child.

Addressing substance use before conception is crucial for improving fertility, reducing the risk of complications and promoting long-term health.

These substances can harm fertility, increase the risk of miscarriage and lead to serious birth defects or developmental issues.

Taking illegal drugs, even in small amounts, can affect how well the placenta functions and the baby's development, even for those considered 'low risk' users.

Partners' drug use, regardless of gender, during the preconception period can also negatively affect fertility, pregnancy outcomes and the child’s future health.

A partner’s ongoing drug use can create an unsafe or unstable environment.

Even if the drug user is not the biological parent, their behaviour can impact the physical and emotional well-being of both the other parent and the child.

Messages for professionals to share around substance use:

• advise women and pregnant people to contact their GP or midwife as soon as they find out they're pregnant
• if an individual uses non-prescription or recreational drugs and is planning to conceive, it is essential to seek support for quitting - addiction counselling and medical treatment can offer guidance and support - quitting drug use before conception helps restore hormonal balance, improves fertility and reduces the risk of complications and birth defects
• preconception counselling and substance use programmes can help identify potential health risks, ensuring individuals enter pregnancy in the best possible health - stopping illegal drugs not only improves fertility and pregnancy outcomes but also creates a healthier family environment, free from the dangers associated with drug use

If a partner is involved in the pregnancy, include both partners in discussions about preconception health and substance use. This promotes shared responsibility and encourages open communication about drug use, fertility and family planning. Providing support and treatment for both partners can improve pregnancy and future child health outcomes.

Resources

Derbyshire Healthcare NHS Foundation Trust - advice, support and treatment to adults in Derby who need help with their drug or alcohol use.

Derbyshire Recovery partnership

Change Grow Live is the young persons' drug and alcohol service in Derby. If you are under 18 and your drug or alcohol use is worrying you or causing problems, Change, Grow, Live can help.

Alcohol

Alcohol consumption before conception can have negative effects on fertility, pregnancy outcomes and a child's long-term health.

Reducing or stopping alcohol intake before conception is important for optimising reproductive health and ensuring a healthy pregnancy.

When family planning is not considered, there is a greater risk of accidental exposure of the foetus to alcohol, which increases the risks to the unborn child.

Drinking alcohol during the early stages of pregnancy, even before a person knows they're pregnant, can increase the risk of fetal alcohol spectrum disorders (FASDs). These conditions cause lifelong physical, behavioural and intellectual disabilities, sometimes resembling conditions like autism or attention deficit disorder.

Drinking alcohol also increases the risk of miscarriage, with heavy drinking or binge drinking during the first trimester being particularly harmful to the development and future life chances of the foetus.

Messages for professionals to share

• advise women and pregnant people to contact their GP or midwife as soon as they find out they're pregnant
• no amount of alcohol is proven to be safe at any time during pregnancy - quitting alcohol before conception lowers the risks of miscarriage, stillbirth and pregnancy complications, it also ensures the developing baby isn't exposed to alcohol during critical early stages of development
• all women and people should be encouraged to reduce or quit alcohol in the preconception period to improve their reproductive health, prevent complications and protect their child's long-term well-being

Resources

Derbyshire Addictions Advice Service (DAAS) ​is staffed by dedicated and experienced professionals and are led by a management team and board of Trustees with years of experience in related areas.

Derbyshire Healthcare NHS Foundation Trust offers advice, support and treatment to adults in Derbyshire who need help with their drug or alcohol use.

Change Grow Live is the young persons' drug and alcohol service in Derby. If you are under 18 and your drug or alcohol use is worrying you or causing problems, Change, Grow, Live can help.

Drymester helps parents-to-be go alcohol free, to keep risks to babies to a minimum. The safest approach is to go alcohol free throughout pregnancy.