[How should markers of smoking be used during pregnancy?]

Consultation or hospitalization for pregnancy, irrespective of the patient's motivation, is always an exceptional opportunity for coupling care for the smoking addiction with antenatal surveillance. In studies on markers of smoking addiction during pregnancy, the most used markers are expired carbon monoxide (CO) and urinary cotinine. Expired CO can be used to estimate the level of active or passive smoking and thus enable the mother to realize the risks for her baby and appreciate how easy it is to decrease these risks. In the future, the quality of perinatal care will depend greatly on improved management of smoking mothers with the objective of reducing fetal exposure. An insufficient amount of work has been done on evaluating the contribution of markers of smoking during pregnancy or feeding. Improvement requires better awareness of perinatal healthcare professionals, measurement of expired CO during pregnancy, implementation of validated medicinal and/or cognitivobehavioral methods, and clearly stated support from political and administrative authorities.