A new review of 127 studies finds that counseling and financial incentives can help pregnant women stop smoking, leading to healthier babies.
Smoking during pregnancy is a leading cause of serious health problems for both mothers and babies. It increases the risk of low birthweight, preterm birth, and other complications that can affect a child for life.
Many women want to quit smoking but find it incredibly hard, especially during the stress of pregnancy. Current support options can feel scattered or ineffective.
This new review looks at what actually works to help pregnant women stop smoking. It covers 127 studies involving over 47,000 women to find the most effective approaches.
The Surprising Shift
For years, doctors have known smoking is bad during pregnancy. But what actually helps women quit? The old advice was often just "stop smoking" without much follow-up.
This review changes that thinking. It shows that structured support—not just a warning—makes a real difference.
But here’s the twist: not all support is equal. Some methods work much better than others.
Think of quitting smoking like climbing a steep hill. It’s hard to do alone, especially when you’re carrying extra weight and feeling stressed.
Psychosocial interventions are like having a guide with a rope. They provide tools, encouragement, and sometimes a little push to help you reach the top.
These interventions include:
- Counseling: One-on-one talks with a trained professional.
- Financial incentives: Small payments or rewards for staying smoke-free.
- Health education: Information about the risks and benefits.
- Social support: Help from family, friends, or support groups.
The goal is to make quitting feel less overwhelming and more achievable.
What the Review Looked At
Researchers searched for all relevant studies up to November 2025. They included 127 randomized controlled trials with over 47,000 pregnant women who were smoking or had recently quit.
The studies compared different support programs against usual care or other interventions. The main goal was to see if these programs helped women quit smoking late in pregnancy and after birth.
They also looked at baby outcomes like birthweight and NICU admissions.
The results are encouraging. Counseling and financial incentives probably help pregnant women quit smoking.
Compared to no special support, psychosocial interventions increased the chance of quitting by about 41% in late pregnancy. In the early postpartum period, the chance of quitting increased by 33%.
Counseling alone was even more effective, increasing quitting rates by 51%. Financial incentives worked best, doubling the chance of quitting compared to other interventions.
Health education and social support also helped, but the evidence was less certain.
This doesn’t mean this treatment is available yet.
Baby Benefits
The good news extends to the babies. When mothers received support, their babies were born heavier on average—about 57 grams heavier, to be exact.
More importantly, babies were less likely to be born with low birthweight (under 2,500 grams). The risk dropped by about 18%.
There was also a trend toward fewer babies needing NICU care, though the evidence was less certain.
However, the review found no clear effect on preterm births or stillbirths. The evidence was too uncertain to draw firm conclusions.
This review confirms what many healthcare providers have suspected: structured support works. Counseling and financial incentives are not just ideas—they are backed by strong evidence.
But the review also highlights a gap. Few studies looked at how these interventions work for ethnic minorities or Indigenous communities. This means we don’t yet know if the same approaches are equally effective for everyone.
If you are pregnant and smoking, talk to your doctor about support options. Counseling and financial incentive programs may be available in your area.
These interventions are not a magic fix, but they can provide the tools and encouragement needed to quit. Quitting at any point during pregnancy can improve outcomes for both you and your baby.
The review has some weaknesses. Many studies had unclear methods, which could affect the results. For some outcomes, the confidence intervals were wide, meaning the exact effect is uncertain.
The evidence was also less certain for certain baby outcomes, like preterm birth.
Next steps include more research to see how these interventions can be tailored for different groups, especially ethnic minorities and Indigenous communities.
Funding is already in place for further studies. The goal is to make sure every pregnant woman has access to effective support to quit smoking.
This review is part of a long-term effort to improve maternal health, with updates dating back to 1999. The latest update, published in April 2026, ensures the guidance stays current for doctors and policymakers.