“I smoke shisha”

“I smoke shisha”.

She replied.

I didn’t see that coming.

From a pregnant woman. Ten weeks gone.

“Do you smoke?”. A question I may have skipped if it was a busier clinic.


Nicotine. Tar. Carbon monoxide. Arsenic. Lead…

Wait. What?

All of those dangerous stuff going down to the developing foetus?


I learnt communication skills because of patients like this. I’m a physician. I shouldn’t be judgemental. I should counsel her. I should explore her knowledge and attitude. I should find out if she wanted to quit. I should show her the benefits of quitting. I should give her information on how to quit for good…

I gathered my thoughts.

Mrs. Fulaan, you need to stop smoking.

“I’ve been trying”.

Ah! I was relieved.

Wanting to quit is a good sign.

Moving forward.

She has read about the risks of smoking to herself and her innocent baby.

The risk of different cancers especially lung cancer.
Blood clots.
Cardiac problems…

Placenta insufficiency.
Placenta abroption.
Preeclampsia and eclampsia.
Fetal growth restriction and low birthweight.
Stillbirth or irreversible brain damage…

These effects increase as the pregnancy grows. Especially during the second half.

And after the baby is born.

Respiratory problems like asthma.
Or sudden infant death.

The best time to quit is now.

I reassured her.

I encouraged her.

I directed her to the smoking cessation programme.

“But my husband smokes too”


He needs to quit, too.

For his health.

For you and your baby’s sake.

Second-hand smoke isn’t passive. It is as bad as it can be.

Let him smoke outside until he stops.

“Thank you doc”

You’re welcome.



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