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4 EVALUATION AND SCREENING The American College of Obstetricians and Gynecologists recommends that clinicians ask about tobacco use (along with secondhand smoking) before pregnancy, throughout pregnancy, and during postpartum periods, and advise patients regarding the significant perinatal risks and the importance of quitting tobacco or nicotine use in any form, including e-cigarettes and vaping

The health risks of smoking are severe and wide-ranging

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Smoking cessation recommendations encourage women to quit smoking entirely in the first trimester of pregnancy, and if they do not succeed to at least gradually reduce the number of cigarettes smoked daily and to completely abandon smoking in the third trimester 27