There is no solid evidence that cutting down the number or strength of cigarettes smoked significantly reduces the risks to the foetus. Stopping smoking completely as early as possible ensures much better health outcomes for the baby and the mother.
Cutting down the number of cigarettes smoked per day is a common strategy used by smokers to reduce harm. However, because smokers seek a consistent level of nicotine, they tend to smoke the remaining cigarettes harder by taking more and larger puffs, and holding each puff longer. Thus they do not reduce their intake of toxins as much as the reduction in the number of cigarettes suggests.
As well, there are a number of misbeliefs about cutting down or use of alternative products that may result in some women using methods that don't lower their smoke intake, or even increase their risk of harm.
- Switching to weaker tasting cigarettes (previously branded "low tar"). Smokers inhale just as much damaging chemicals from each cigarette as they did from their previous brand. Less harsh smoke is not less dangerous.
- Switching to "chop chop" – loose untaxed tobacco also known as "natural tobacco". Many of the damaging chemicals in cigarette smoke, including carbon monoxide, tar and nicotine, come from burning the tobacco plant itself. It is not healthier to smoke this kind of tobacco, and there may be additional risks from mould spores.
- Switching to roll-your-own (RYO) cigarettes. Research suggests that RYO tobacco is at least as harmful or possibly more harmful than smoking factory-made cigarettes.
- Using waterpipes, particularly among women in the Middle-Eastern community. Waterpipes are widely perceived as being less addictive, less harmful and "cleaner" than cigarette smoking. However, waterpipe smoking is both addictive and harmful. Babies born to pregnant women who use waterpipes have an increased risk of troubled breathing and of having a low birth weight, which makes them more vulnerable to illness and death.
- Switching to or partly substituting tobacco with cannabis. Cannabis use increases the likelihood of having low-weight baby who is more vulnerable to illness, death and long-term problems in adulthood.