Introduction:
Despite the fact that the association between smoking and Gestation Diabetes Mellitus (GDM) is not clear, it is evident that pregnant smokers have 2h lower plasma glucose after an Oral glucose tolerance test and a higher HbA1c. Active maternal tobacco smoking and second hand smoke exposure during pregnancy is certainly the most important preventable cause for a variety of unfavorable pregnancy outcomes.

Aim: Our study aimed at exploring potential new strategies in performing smoking cessation on pregnant women with GDM.

Methods:
Our study was a review of the international bibliography on Smoking Cessation on Pregnant women with GDM.

Results:
Smoking cessation programs in pregnancy are effective and should be implemented as part of routine care for every pregnant smoker. Especially on pregnant smokers with GDM, emphasis should be laid on the fact that provided they quit, there is a good possibility that they might also benefit from needing fewer insulin doses or a less strict diet to follow. It is therefore considered essential for Maternity clinics to have a health professional specially trained in smoking cessation who can provide behavioral support on women who want to quit. Since quitting smoking may be incredibly difficult for a considerable amount of pregnant smokers and since relapses are frequent, the support provided to women in their effort to quit should be continuous throughout pregnancy. The classical 5A’s approach could be shortened into just 3A’s: Ask, Advice, Act. Cognitive behavioral support, motivational interviewing and structured self-help represent for pregnant women their best chance for quitting. Also, from the pharmaceutical treatment perspective, only NRTs could be used in pregnancy.

Conclusions:
Pregnant smokers with GDM have more complicated pregnancies because of both smoking and gestational diabetes risks. Regardless, all pregnant smokers should be encouraged by knowing that help is always available and that quitting is always feasible.