Background:
Tobacco use does not cause problems only to users but also to others around them. A critical problem is tobacco use during pregnancy. This attitude could affect not only the health of the mother but also that of the fetus.

Objective:
This study aimed to evaluate the level of smoking in pregnant women and the connection of smoking with problems to the fetus.

Methods:
This was a cross-sectional study conducted in the city of Vlora, Albania, over the period June 2019 – June 2021. Two healthcare centers located in the city of Vlora (urban area) were selected for data collection. In each, questionnaires were distributed only to primiparous women during the time they presented for checks, but interviews were conducted with mothers who gave birth during this period and visited for routine checks.

Results:
In total, 1330 women participated in the study, of which 940 women were pregnant and 390 who had given birth. Of these, 28% were smokers before pregnancy, and 8% did not quit smoking while pregnant, and 3% reported that they started smoking with the onset of the pandemic. In all, 5% of the women smokers had a miscarriage, while 10% of women who smoked gave birth to babies of low birth weight, and 6% of the women who smoked gave birth prematurely. Sudden Infant Death Syndrome (SIDS) and placenta previa occurred in 2%. Mothers who reported having less breast milk and were smokers were 9%.

Conclusions:
This study confirms that there is a connection between fetal complications and maternal smoking. Quitting smoking significantly reduces the health risks of the fetus and newborns and minimizes fatalities. Since smoking causes serious health problems for both mother and baby, it is necessary to have more consulting sessions with smoking mothers. It is also recommended that smoking should be stopped at the moment of conception or at any moment during pregnancy. Education of future mothers from healthcare personnel for tobacco cessation should be a priority of healthcare systems.