Cannabis vs. Tobacco During Pregnancy: The Bottom Line
If you are pregnant and using either substance, the safest choice is to stop both. Tobacco has decades of research proving harm to both mother and fetus. Cannabis has less research, but the evidence is growing and concerning. Neither is a safe option. Tobacco is the more studied risk, but cannabis is not a harmless alternative.
cannabis and pregnancy third trimester
Why Tobacco Is the More Proven Danger
Smoking cigarettes during pregnancy exposes the fetus to nicotine, carbon monoxide, and thousands of other chemicals. This reduces oxygen supply and can cause premature birth, low birth weight, birth defects, and even infant death. The CDC states that smoking during pregnancy increases the risk of sudden infant death syndrome (SIDS). Secondhand smoke is also harmful. There is no safe level of tobacco exposure during pregnancy.
Why Cannabis Is Not a Safe Substitute
Cannabis smoke also contains carbon monoxide and tar. THC crosses the placenta and can affect fetal brain development. The American College of Obstetricians and Gynecologists (ACOG) advises that cannabis use during pregnancy may be linked to low birth weight and preterm birth. The Surgeon General warns that cannabis use during pregnancy or breastfeeding may harm the baby. No safe amount has been established. Using cannabis to relieve pregnancy symptoms like nausea is not recommended; safer treatments exist.
Cannabis and Pregnancy Studies: What the Research Shows
What to Do Instead: Step-by-Step
- Talk to your doctor or midwife about your tobacco or cannabis use. Be honest and ask for help without judgment.
- Set a quit date. Choose a specific day within the next two weeks to stop all tobacco and cannabis products.
- Remove all cigarettes, vaping devices, and cannabis products from your home and car.
- Avoid triggers. Identify situations where you usually use (like after meals or with certain people) and make a plan to avoid them.
- Ask about nicotine replacement therapy. If you smoke tobacco, your doctor may recommend gum, lozenges, or patches. These are safer than continued smoking.
- Start counseling or join a support group. Behavioral therapy doubles your chances of quitting for good.
- Exercise and rest. Gentle activity and adequate sleep reduce stress and cravings.
- Check in with your doctor regularly. Adjust your plan as needed and celebrate each milestone.
Options for Support
- National quitlines and text message programs (available in many countries).
- Prenatal care providers who specialize in substance use during pregnancy.
- Cognitive behavioral therapy (CBT) for cannabis dependence.
- Peer support groups for pregnant women and new mothers.
If You Use Cannabis for Medical Symptoms
Some pregnant women use cannabis for nausea or appetite. Nausea during pregnancy is common, but cannabis is not the answer. Safe alternatives include vitamin B6, doxylamine (with your doctor's approval), ginger, and small frequent meals. Do not start or continue cannabis without discussing it with your obstetrician. The risk to the developing brain is too high.
The Verdict
Tobacco is the more dangerous choice during pregnancy because its harms are well-documented and severe. Cannabis, however, is not safe. If you already use either, quitting now is the best thing you can do for your baby. Ask for help and take one step at a time.