Smoking cessation during and after pregnancy can confer many health benefits to women and their children. Smoking behavior can fluctuate from quitting or reducing during the first trimester to relapses later in pregnancy and postpartum. Abstinence during pregnancy is associated with level of addiction, socioeconomic status, level of education, maternal age, age to start smoking, partner's smoking habit, and secondhand smoke exposure. Low-barrier interventions that reach impoverished and disadvantaged women who are most at risk for smoking and also have the hardest time quitting are needed. At a minimum, pregnant smokers should be offered self-help materials and a 10-minute face-to-face psychosocial intervention. Offering incentives to pregnant women to quit smoking is the most effective intervention. Data are inconclusive regarding the efficacy of smoking cessation pharmacotherapy during pregnancy and postpartum. Because there are also safety concerns about fetal exposure, the use of pharmacotherapy for pregnant women remains controversial.