Smoking during pregnancy: in France, almost 27 % of women were smoking one year before their pregnancy in 2021, and 11.8 % were still smoking in the third trimester. These figures from Santé publique France (the French public health agency), published in July 2026, show a real decline over ten years. They also show marked regional differences and a frequent return to smoking after the birth.
Here is what the official data say, what they don't say, and where to find free help to quit.
Smoking and pregnancy: what do the Santé publique France figures say?
The figures come from the 2021 National Perinatal Survey (Enquête nationale périnatale). This national survey, repeated every few years, questions women who give birth during a given period. Santé publique France included them in its press pack on perinatal health dated 8 July 2026.
- Almost 27 % of women reported smoking one year before their pregnancy.
- 11.8 % were still smoking in the third trimester, thanks to a significant reduction in smoking during pregnancy.
- Two months after giving birth, more than 15 % had started smoking again.
In other words, most smokers cut down or quit during pregnancy. But a significant proportion of them start again in the weeks after the birth. Santé publique France sees this as a sign of how hard it is to stay smoke-free in the long term.
A clear decline between 2010 and 2021
In mainland France, the proportion of women smoking in the third trimester fell from 17.1 % in 2010 to 12.2 % in 2021. That is a drop of almost five points in just over ten years.
Santé publique France notes a marked acceleration between 2016 and 2021. In this document, the agency does not attribute it to any single measure. The decline is part of the wider fall in smoking seen in France over the same period.
The 11.8 % figure and the mainland figure of 12.2 % do not contradict each other. The difference is most likely down to scope: the French overseas departments and regions, where rates are generally lower, pull down the overall average.
A threefold gap between regions
The national average hides very different situations. In 2021, the proportion of women smoking in the third trimester varied threefold from one region to another.
- 5.9 % in Île-de-France, the lowest proportion in mainland France.
- 17.1 % in Hauts-de-France, the highest.
- In the overseas departments and regions, from 1.3 % in Mayotte to 8.8 % in Réunion.
These gaps mirror those seen for other perinatal health indicators. They are a reminder that prevention does not reach everyone in the same way, or at the same time.
Why is smoking during pregnancy a risk for the baby?
Because smoking during pregnancy is a major, well-documented risk factor for both mother and child. Santé publique France cites four main harmful effects.
- Placenta praevia, meaning a placenta attached too low in the womb.
- Ectopic pregnancy.
- Low birth weight.
- Premature birth.
Premature birth and low birth weight then weigh on the first weeks of life. We look at these issues in detail in our article on premature birth in France. For a baby born early, developmental milestones are read using the corrected age of a premature baby.
Exposure to smoke doesn't stop at birth. Once the baby is born, smoking in the home exposes them directly. The data on this exposure are brought together in our article on passive smoking and babies.
Cutting down or quitting: what the figures suggest
The drop from 27 % before pregnancy to 11.8 % in the third trimester tells us something simple. Pregnancy is a time when many women manage to change their smoking habits. It is also a time when they often see health professionals.
Relapse after the birth shows the other side of the picture. Lack of sleep, tiredness and the upheaval of the first weeks make a recent quit fragile. Support is therefore most useful when it carries on after the birth, not just during pregnancy.
It is worth remembering what the data do not measure. They are based on what the women surveyed reported themselves, which may lead to actual smoking being underestimated. Nor does this document break down the number of cigarettes smoked per day.
Where can you find free help to stop smoking while pregnant?
Santé publique France lists several free services, open to pregnant women and to the people around them.
- 39 89, the Tabac info service helpline: free, personalised support from a stop-smoking specialist, by phone.
- The Tabac info service app: a personalised support programme to help you prepare to quit and track your progress every day.
- The tabac-info-service.fr website: advice and information on ways to quit.
- The “Grossesse sans tabac” (smoke-free pregnancy) leaflets, which explain the possible consequences of smoking and the treatments available to help you quit.
Your midwife, GP and gynaecologist are also natural people to talk to. The subject can be raised at every antenatal appointment, without waiting for a dedicated one.
Support from your partner and loved ones matters too. Quitting is easier to stick to in a home where nobody smokes indoors. It is also the best way to protect your baby-to-be from smoke.
Smoking among other prevention measures
In the same press pack, Santé publique France points to other prevention measures that are still underused. In 2021, only 27.2 % of women were taking folic acid before their pregnancy. Only 15.7 % received prevention advice about cytomegalovirus.
We have written articles on both topics. The first covers congenital anomalies in France. The second looks at CMV screening during pregnancy, recommended by the Haute Autorité de santé (the French national health authority).
After the birth, a smoke-free home sits alongside safe sleep rules among the measures to prevent sudden unexpected death in infancy. They are explained in our article on safe sleep for babies.
When are the next figures expected?
Santé publique France has announced that its population surveys will continue, including the ENP-Epifane survey planned for 2027. This will be the next opportunity to find out whether the fall in smoking during pregnancy has continued since 2021.
Until then, the 2021 figures remain the national benchmark. We will update this article when the new results are published.
Key takeaways
- In 2021, almost 27 % of women were smoking one year before their pregnancy, and 11.8 % in the third trimester.
- In mainland France, the proportion of smokers in the third trimester fell from 17.1 % in 2010 to 12.2 % in 2021.
- Regional figures range from 5.9 % in Île-de-France to 17.1 % in Hauts-de-France.
- More than 15 % of women had started smoking again two months after giving birth.
- The 39 89 helpline offers free support from a stop-smoking specialist.
Sources
- Santé publique France, press pack “Santé périnatale: 10 années d'évolutions contrastées”, 8 July 2026. Data from the Enquête nationale périnatale 2021.
- Santé publique France, Tabac info service: 39 89 helpline, app and tabac-info-service.fr website, presented in the same press pack.
