Tobacco Free Initiative (TFI)

WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy

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World Health Organization

Publication details

Number of pages: 104
Publication date: 2013
Languages: English, Russian
ISBN: 978 92 4 150607 6

Full version

Short version


Tobacco use and second-hand smoke (SHS) exposure during pregnancy have adverse health effects on women and infants. Potential increases in tobacco use and SHS exposure among pregnant women threaten to undermine improvements in maternal and child health outcomes achieved in the past 50 years.

There are currently no up-to-date, evidence-based guidelines for identifying and managing tobacco use and exposure to SHS in pregnancy in most of low- and middle- income countries. Furthermore, many existing guidelines do not include all forms of tobacco use or measures to limit maternal SHS exposure. To fill this gap, the WHO has developed the “WHO Recommendations for the Prevention and Management of Tobacco use and Second-hand Smoke Exposure in Pregnancy”. The guidelines were developed by an independent Guidelines Development Group.

The primary objective of these guidelines is to reduce tobacco use and SHS exposure in pregnant women by providing evidence-based recommendations to health-care providers and other related service providers.

These guidelines cover the following issues:

  • Elements necessary for effective screening of pregnant women for tobacco use (smoked and smokeless) and SHS exposure.
  • Safety and effectiveness of psychosocial and pharmacological interventions for tobacco use in pregnancy.
  • Effective interventions for reducing SHS exposure.
    • at work and in public places,
    • at home.

These recommendations are part of a larger project of the WHO Noncommunicable Diseases and Mental Health, which aims to make recommendations regarding the management of substance abuse in pregnancy, covering tobacco, alcohol and other psychoactive substances.