How can I quit smoking before or during pregnancy?

Ideally, you should stop smoking before you conceive. The fact is, you may not know you're pregnant for the first eight weeks, and that's a lot of time to expose a fetus to chemicals in smoke. But any time you quit is a great time, because when you're pregnant, you're smoking for two.

Smoking while pregnant puts both you and your baby at risk. Smoking during pregnancy can cause complications during delivery such as premature rupture of membranes, abruptio placentae, placenta previa, premature birth, low-birth-weight, stillbirth and sudden infant death syndrome (SIDS).

Before pregnancy, you can use almost any approach to kick the habit, including behavioral methods, nicotine replacement products (gum, patches and inhalers), antidepressants and smoking cessation drugs. But during pregnancy, some of the medications may not be safe. These agents may pass through the placenta to reach your baby.

Here's my advice to pregnant women:

• Set a date to quit and stick to it.
• Enroll in an online smoking cessation program (they can walk you through quitting, and they're free).
• Exercise every day.
• Keep a journal.
• Identify and avoid your triggers, like the urge to smoke after dinner.
• Don't let friends or family smoke in front of you.
• Change your routine.

Quitting smoking before becoming pregnant gives you more treatment options. Medications such as Chantix (varenicline) or bupropion, as well as nicotine patches, gum, and sprays, are generally not considered safe for use by pregnant women, because they may harm a developing fetus. However, smoking is also harmful to a fetus, so you must balance risks and benefits when deciding if you should use smoking cessation medication while pregnant. Counseling and support programs are also successful.