We have known for sometime now that smoking during pregnancy can increase the risk of miscarriage, infertility, some pregnancy problems, premature birth, low birth weight babies, more babies dying before and after birth, increased respiratory problems and the risk of cot death. What has not been known until now is how smoking increases the risk of cot death by more than three times. Scientists have now discovered not only how smoking is directly linked to cot death but that it is in fact one of the greatest risks factors. Nicotine that is found in tobacco damages special receptors in the baby’s brain. These receptors are vital because they help keep sleeping babies breathing. It is quite common for babies to have short pauses in their breathing when they sleep. After a few seconds of not breathing these special receptors in a baby’s brain will kick in and make the baby breath again. These receptors are found in the same place where nicotine from smoking also lodges. Smoking in pregnancy enables the nicotine to pass into the unborn baby’s system and lodge in the brain. This makes the special receptors needed to kick start breathing less effective, thus increasing the risk of cot death. Australian data from 1998 indicating that nearly one in five women smoked during pregnancy. Quitting smoking early in pregnancy reduces the risk of cot death and other adverse outcomes. There is no doubt that smoking is a hard habit to kick and women need a great deal of support and understanding when trying to do this. Behavioural tips like the ‘five Ds’ can help women when ever they feel the urge to smoke: delay (even for a short while); drink water; deep breathing; do something different and discuss the craving with another person.