Being Honest About Why You Smoke

Smoking and pregnancy

Being Honest About Why You Smoke

The choices you make when you’re pregnant affect your baby’s health as well as yours. Now you're pregnant, there’s never been a better time to stop smoking. The earlier you stop smoking in your pregnancy, the better.

There’s no safe amount when it comes to smoking. Any amount damages your health and your baby’s. Cutting down or switching to low-tar cigarettes isn't enough. The safest thing is to stop smoking completely.

Hidden risks

When you smoke, you breathe in a cocktail of dangerous chemicals, including a gas called carbon monoxide.

You can’t see or smell it, but it’s harmful to you and your baby because it affects how your body uses oxygen.

Carbon monoxide:

  • affects how your baby grows and develops.
  • makes health problems more ly during your pregnancy and when you give birth

Testing for carbon monoxide

You will have a carbon monoxide test at your first antenatal appointment.

You blow into a machine which measures the carbon monoxide in your body and you get the results straightaway.

If the result is 4 or more your midwife will ask you whether you smoke, or whether you live in a house where someone else smokes. It’s best to be honest, so your midwife can get you the right help.

Reasons to quit smoking

Smoking doesn’t make labour or birth any easier or less painful, and it won’t affect the size of your baby’s head. But smoking can slow down growth, which means your baby could have health problems.

By stopping smoking:

  • you reduce the risk of having a miscarriage or your baby being stillborn
  • you reduce the risk of sudden unexpected death in infancy (SUDI), previously known as cot death
  • your baby's more ly to be born a healthy weight and full-term (at around 40 weeks) — babies born too early and underweight are more ly to have feeding and breathing problems
  • your baby's less ly to be born with health problems asthma or a cleft lip and/or palate
  • you’ll look better, smell better and feel better
  • you’ll lower your risk of heart disease and cancer
  • you'll save money — just a month of not smoking could save you around £200 to spend on you and your baby

It's good for you and your baby to stop at any point – the benefits will start straight away.

E-cigarettes and vaping

E-cigs are not risk free.

There’s no evidence yet on the effects of long-term use.

The risks to a fetus are unknown.

E-cigs are almost certainly less harmful for you than tobacco smoking, but the main aim is to stop using any cigarettes.

Second-hand smoke

If you live with a smoker or spend lots of time with someone who smokes, you’ll be breathing in their smoke too. This is called second-hand smoke.

Second-hand smoke is harmful for you and your baby. The chemicals linger in the air and can still be in the room 5 hours later. Opening windows or smoking in another room or a window won’t help.

When your baby's born and you bring them home, ask anyone who cares for them to smoke outside or stop.

Any car your baby's in must also be smoke free. It’s illegal to smoke in a car when someone under 18 is inside.

Getting support

If you smoke, you’ll probably have thought about stopping at some time. You may even have tried to stop more than once. If you have then you’ll know how hard it is.

It can be hard to tell your midwife you’re a smoker. Some women feel:

  • embarrassed
  • guilty
  • under pressure to stop.

Others think they might be judged or worry about what people think. These are natural worries but talking to your midwife can help you get the right support. Your midwife won’t judge and just wants to help.

Getting help to stop smoking

Supporting your partner

Dads and partners can help mum to stop smoking or stay smoke-free by:

  • distract her when she wants to smoke
  • helping her to plan, manage and change some of the routines when she might want to smoke
  • being patient when she’s finding it tough

If you also smoke:

  • do it outside and away from your partner and your baby and keep your car smoke-free too
  • try to quit together and support each other so you’ll both be less tempted to smoke

Translations and alternative formats of this information are available from Public Health Scotland.


How Do Health Insurance Companies Know if You Smoke?

Being Honest About Why You Smoke

The next time you sign up for health insurance, you’ll be asked whether you smoke and how often. If you smoke or vape or chew tobacco regularly, you can count on being hit with a hefty premium increase of up to 50%, either at work or if you’re buying an Affordable Care Act (ACA) Obamacare plan on the Exchange Marketplace.

Despite the deadly dangers of smoking — with lung cancer now the No. 1 cancer threat to men and women — 34 million Americans still smoke regularly (14% ) and another 6 million use vaping nicotine inhalers.

The Federal Drug Administration labeled inhalers as “tobacco products” in 2016, and, therefore, so do most health insurers. With that ruling, you can say the old tobacco policies went up in smoke.

So if you smoke or vape, you need to understand the legislation and the probable higher costs of your health insurance. Not to be cheeky, but you’ll pay through the nose. 

How Do Health Insurance Companies Know If You Smoke?

Health insurers consider you a smoker, subject to a hefty premium surcharge if you used any tobacco products four or more times a week in the past six months. 

Some regular smokers facing a steep premium increase may be tempted to avoid telling the truth. Don’t do it. If you’re not honest about tobacco, you risk being charged with insurance fraud.

Even such “soft fraud” is considered a misdemeanor and can result in sentences of probation, community service — or even time in jail.

Not to mention, you’ll very ly lose your insurance or at least be charged all the back money you owe as a smoker. 

Although it’s nearly unheard of for an insurer or employer to actively investigate whether you smoke, your doctor will probably note tobacco use in your medical records as a result of routine blood and urine analysis. That paper trail could be uncovered and flagged as your insurer is reviewing your treatment before paying your bills. 

Obviously, being honest when you answer enrollment questions is in your best interest.

What Is a Tobacco Rating?

Health insurance premium levels depend on five key factors:

  • Your age
  • Where you live
  • Your plan category
  • Your number of dependents
  • Your tobacco use

The practice of demanding a surcharge for tobacco use is known as tobacco rating. Insurance companies and some experts justify the large surcharge acts as an incentive to convince smokers to quit.

When Does Tobacco Rating Apply? 

Truly casual smokers may be able to avoid tobacco surcharges. Tobacco use must rise to a certain level before health insurance companies can penalize you.

According to the federal Department of Health and Human Services, insurance companies consider folks tobacco users if they use tobacco products – including cigarettes, cigars, pipe tobacco, and chewing tobacco – on average four or more times a week during the past six months. 

One exemption to this ruling is religious or ceremonial uses of tobacco products, for example, by American Indians and Alaska Natives.

A Few States Moderate Tobacco Rating 

Not all states have the same Tobacco Rating rules. Currently, seven states plus the nation’s capital prohibit insurers from charging smokers extra: 

Three other states allow a surcharge of less than 50% : 

  • Arkansas – 20%
  • Colorado – 15%
  • Kentucky – 40%

In the other 40 states, smokers can be charged 50% more for monthly premiums compared to non-smokers. In addition, the smoking surcharge does not qualify for ACA premium subsidies; you pay the premium entirely your pocket. 

Costs for Smokers Versus Non-Smokers

Although health insurance companies are allowed to charge smokers up to 50% more for premiums in most states, some “smoker-friendly” carriers do not.  If you smoke, you may be able to find one of these companies if you shop hard enough. 

Smoking and the Affordable Care Act

By law, all ACA  Obamacare health plans cannot reject tobacco users. Still, they are allowed to use the Tobacco Rating to boost premiums by up to 50%. However, they cannot raise your copayments or coinsurance.

In addition, if you intend to quit tobacco use — as you should for your health and those around you — cessation programs are included as preventive care under the ACA’s 10 essential health benefits. You won’t have to pay any out-of-pocket costs for most smoking cessation programs, which can include counseling, a prescription cessation medication, and replacement therapies.

Juuls, E-cigarettes, and Vaping

As noted, roughly 6 million people over 18 are using electronic nicotine-inhaling devices, such as Juuls, e-cigarettes, and vapes. These products don’t use tobacco; however, they contain other harmful substances, including addictive nicotine. Authorities note that more than 2,000 people from age 13 and up got sick from vaping last year and over 50  died.

Because inhaler products lack tobacco, e-cigarette users may wonder whether they must identify themselves as smokers when signing up for health insurance. If you have doubts, contact your health insurance company and discuss your e-cigarette habits. 

One more note, nicotine inhalers have been marketed as helping some people wean off their nicotine dependency and quit smoking altogether. But do not expect your insurer to be sympathetic to that argument for lower costs. Studies show that people who tried to quit with inhalers were 67% less ly to be successful compared to other cessation methods commonly covered by insurance plans. 

Once You Join a Plan as a Tobacco User

If you begin smoking regularly after you’ve joined a health insurance plan, you should tell your health insurance company when you renew your coverage (usually at the start of the year), if not sooner. By being truthful with your insurance company, you can save yourself all sorts of onerous complications down the road.

The potentially grave consequences for misrepresenting your tobacco use should convince you to always be transparent.

Once you are insured, remember that smoking remains the leading preventable cause of death, so you should consider taking advantage of the free cessation programs that can help protect you and the health of those close to you.


Life Insurance For Smokers

Being Honest About Why You Smoke

Editorial Note: Forbes Advisor may earn a commission on sales made from partner links on this page, but that doesn't affect our editors' opinions or evaluations.

Compare Policies With 8 Leading Insurers

If you’re a smoker, you’re probably well aware of the fact that it can impact your health. Cigarette smoking is the leading cause of preventable disease, disability and death in the U.S., according to the Centers for Disease Control and Prevention. Smoking accounts for 480,000 deaths (or 1 in 5 deaths) per year. 

And here’s another unpleasant side effect of smoking: significantly more expensive life insurance rates. Smokers can pay nearly four times more for a life insurance policy compared to someone who doesn’t smoke. 

Why Do Smokers Have Different Life Insurance Rates?

Life expectancy is the basis for life insurance rates. So factors that impact your potential “mortality,” or life insurance expectancy, are factored into life insurance quotes.

Cigarette smoking among adults is at an all-time low of 14%, according to a 2020 report from the Surgeon General. But 16 million Americans have a smoking-related disease. And you don’t have to already have health consequences in order to get stuck with higher life insurance rates. Simply being a smoker will usually push you into higher rates when you shop for life insurance.

What Counts as “Smoking”?

So what counts as smoking? Cigarettes are an obvious candidate. But there are many other forms of “nicotine delivery systems” that can peg you as a “smoker,” “tobacco user” or “nicotine user” when you’re shopping for life insurance:

  • Vaping & e-cigarettes
  • Bidis (thin hand-rolled cigarettes)
  • Cigars
  • Pipes
  • Hookahs
  • Chewing tobacco
  • Snuff
  • Dissolvable tobacco
  • Nicotine replacement therapies (patches, lozenges, gum, inhalers, nose sprays)
  • Heated tobacco products

Marijuana users are sometimes also considered smokers, depending on whether the use is occasional or regular.

Regular cigar smokers will usually be considered smokers. But many life insurers will give you a non-smoking rate if you smoke cigars infrequently, such as one or less per month.

Whether or not you’re a “smoker” is decided by each life insurance company, and the parameters can vary significantly. For example:

  • Prudential is generally lenient when it comes to cigar smokers. They consider you a non-smoker if you haven’t had a cigarette in 12 months, but you can smoke a pipe, cigar, or chew tobacco. However, you may not get the best non-tobacco rates.
  • Legal & General America will consider you a smoker if you’ve used any of these in the last 12 months: Cigarettes, pipes, smokeless tobacco, chewing tobacco, nicotine substitutes such as patches and gum, electronic cigarettes, vaping.

Smoking vs. Non-Smoking Life Insurance Rates

Brace yourself for high life insurance quotes if you’re a smoker. We found that smoking rates will easily be double or triple a non-smoking rate. The increase will vary by your age, gender and the coverage amount, but here are examples of average quote increases for a 20-year, $500,000 term life insurance policy.

How Do Life Insurance Companies Find Out That You’re a Smoker?

When you fill out a life insurance application, it’s crucial to be truthful with all your answers. Life insurance companies have many ways to verify everything you’ve stated on the application.

A primary method of verification is with a life insurance medical exam, which typically includes taking blood and urine samples. These samples will reveal cotinine in your system, which is a byproduct of nicotine. Cotinine can also be detected in saliva and hair samples. But testing for cotinine isn’t foolproof. Smokers may be able to slip through if they haven’t smoked in a day or two.

About 23% of life insurance applicants who use tobacco don’t disclose it on applications, according to ExamOne, which performs medical exams for life insurance companies. That’s the number of people who had cotinine in their urine tests but said they didn’t use tobacco.

Applicants ages 18 to 29 are most ly to fail to disclose their tobacco use (25.8%), according to ExamOne.

Life insurance companies have a keen interest in weeding out smokers who aren’t telling the truth. Life insurers lose an estimated $3.4 billion a year in premiums because of undisclosed tobacco use, according to Verisk, a data analytics provider.

Among the other ways a company could find out if you’re a smoker or use another type of nicotine:

  • Doctors’ records. Requesting your medical records is a routine part of many life insurance applications. Nicotine use will ly be noted in your records.
  • Pharmaceutical databases. Life insurers often get lists of your past and current prescriptions. Nicotine use might show up here, such as a prescription for a smoking-cessation drug.
  • Past life and health insurance applications. A company called MIB stores your past answers to individual life and health applications. If your past answers are different, it would be flagged here.
  • Social media. Insurance companies are increasingly using social media sites such as  to look for evidence of factors that affect rates.
  • The sound of your voice. Verisk provides life insurance companies with analytics that predict whether you’re a smoker from the sound of your voice, combined with other data such as demographic and socioeconomic information. When you answer life insurance application questions over the phone–a common step called a tele-interview–you could be recorded. Verisk can analyze these recordings and flags people who are ly to be smokers.

Avoiding a Life Insurance Medical Exam

Not all life insurance policies require a medical exam. Some policy types such as guaranteed issue life insurance require no exam and have no health questions. Rates are your age, gender and coverage amount.

Because the life insurer has no health information from you, these types of policies are among the most expensive you can buy. They also tend to offer only low amounts of coverage, such as $5,000 to $25,000. You can still be better off buying a traditional life insurance policy and resigning yourself to taking the medical exam and paying smokers’ rates.

How Long do You Have to Quit Smoking to be Considered a Non-Smoker for Life Insurance?

Generally if you haven’t smoked for 12 months or more, you’re considered a non-smoker. The non-smoking time length rules vary among insurance companies.

What if I Start Smoking After I Buy Life Insurance?

Once you buy a policy, a life insurance company can’t raise your rates. So if you start deep-sea diving or smoking afterwards, you’ll still enjoy the life insurance rates you already locked in. The same is true for health conditions you develop after buying a policy.

The risk for life insurers that you’ll start smoking later in life is pretty low. Nearly 90% of cigarette smokers first try cigarettes before age 18, according to the Centers for Disease Control.

How to Find the Best Life Insurance Smoking Rates

The key to finding the best life insurance rates–whether you use nicotine or not–is shopping around. By getting at least a few life insurance quotes you’ll get a sense of what’s a good deal.

An independent life insurance can help you shop the market and get quotes from companies that tend to be nicotine-friendly.

What If I Quit Smoking Later?

If you purchased a life insurance at a smoking rate and have now quit for at least a year, you may be able to get a better price. You can ask your life insurance company how long you have to quit to be considered a non-smoker.

If you’ve passed that time threshold, you can ask for the rate to be reconsidered. That means you’ll take a new life insurance medical exam and your health will be re-evaluated. If you’ve also developed new medical conditions in the interim, those will factor into the new rate, too. So keep in mind that getting a re-rating isn’t necessarily a slam dunk after you’ve quit smoking.

Life Insurance for Smokers FAQ

Smokers can buy life insurance but should be prepared for much higher rates than non-smokers. That’s because smoking impacts your life expectancy.

You could be denied a life insurance policy if you lie on the application about your smoking habits. Many insurers require a life insurance medical exam that includes blood samples and urine tests that screen for nicotine use. 

You could also be denied if you have medical conditions in addition to smoking. Work with an experienced life insurance agent who can identify companies most ly to insure you.

Forbes Advisor’s analysis of life insurance quotes found that a smoker can pay about four times as much for life insurance as a non-smoker.

For example, we found that a healthy 40-year old male of average weight and height would pay $397 per year for a 20-year $500,000 term life insurance policy.

A 40-year old male of average weight and height who smokes would pay $1,531 a year for the same coverage. 

If you are a smoker, you’ll pay higher life insurance rates but that doesn’t mean you shouldn’t still shop around for competitive quotes. Rates will vary significantly by company. 

The best strategy is to compare life insurance quotes from multiple insurance companies. You can also work with an independent life insurance agent who can help you with comparison shopping.

Compare Policies With 8 Leading Insurers


The 6 most scientifically proven methods to help you quit smoking

Being Honest About Why You Smoke

  • Some 90% of those who try to quit, will start smoking again, despite their best efforts
  • What works best is to be mentally prepared
  • Quitting smoking is considered one of the hardest bad health habits to break

(CNN)For more than 50 years we've known that smoking can kill you.

It is still the leading cause of preventable death in the United States and yet 42.1 million people light up and new smokers start every day.

«Smoking is my best friend,» Atlantan Barry Blackwell said. «It's always with me long after friends have left and people have gone, they are always here.»

To help people who do want to quit, scientists have looked with great interest into what works. Especially since studies have shown that 90% of those who try to quit, will start smoking again despite their best efforts.

Here are some options that have been scientifically proven to work, at least some of the time.

Financial benefit from quitting, may be your best bet — literally — particularly if you risk losing your own money.

A new study that runs this week in the New England Journal of Medicine shows some promising results. Looking at more than 2,500 people enrolled in a CVS Caremark program, the study found people who had a financial incentive to quit had some remarkable success, at least after 12 months of trying.

The most successful program was one in which a person deposited $150 first. The person would get that plus $650 more if they successfully refrained from smoking. People in that program also got advice on quitting, access to a free counseling program and were offered nicotine-replacement therapy gum or the patch. Of those people, 52.3% quit.

The next biggest group to quit, got an $800 incentive (without having to put down a deposit) and the other resources. Only 17.1% were successful with the larger payout but no potential loss of their own money.

Cold turkey

Only the most disciplined among us can quit without any help. Studies show only about 4-7% can do it without any additional help.

If you want to try this method, what works best is to be mentally prepared, the experts say, and really commit to it. Also, get ready for the symptoms of withdrawal.

The folks at suggest you drink water when the cravings start. Distract yourself with something else. Maybe go for a walk or go talk to someone. Try breathing deeply and slowly and think it though. It'll be tough, but the feelings will pass.

One other thing that could help is to ask for support. Let your friends and family know that you are trying to quit. They can help keep you honest.

Find company

Love can help you through, according to a study that ran in the journal JAMA Internal Medicine.

Just less than half of the men in that study were successful in their attempt to quit if their partner also quit, compared to 8% success if their partner did not stop. Similarly, half of women quit if their male partners also quit smoking. Positive peer pressure seems to help.

Inhalers, nasal sprays, lozenges, gum and skin patches that deliver nicotine slowly are designed to help smokers get over the initial cravings and symptoms of withdrawal. And they do seem to help.

A scientific literature review that looked at more than 150 different tests of these devices (accounting for more than 50,000 people) showed that the lihood someone would quit when using them increased by 50-70%. No one method seemed to work better than the other, nor did these devices work any better (or worse) with counseling.

The study does caution that people considered heavier smokers may need to use more product than lighter smokers. Starting to use one of these NRTs shortly before you really make up your mind to quit may make them more effective. People who use NRTs in combination with the antidepressant bupropion also show additional success.

Prescription drugs

Talk to your doctor if you want to take the prescription route, but there are some drugs that seem to have some success, especially if used with an NRT. In addition to drugs bupropion, there's something called varenicline, also known by the brand name Chantix.

This works by targeting the nicotine receptors in your brain. That means you don't get as much pleasure from smoking and it lowers your feelings of withdrawal.

Some studies have shown taking this drug can more than double your chances of quitting compared to taking no drugs at all.

The jury is still out on this method.

In 2014, a study that ran in the British journal the Lancet found of the 657 people trying to quit over a period of six months, e-cigarettes did help about 7.3% to quit. That was more than the 5.

8% of the people in the study who used a patch. What stood out most to the study's authors was that so few the people were successful quitting using any method.

They concluded more research is urgently needed.

Another group that presented their research at the American Thoracic Society Conference in 2015 found that while some people did quit using e-cigarettes rather than regular cigarettes, they didn't necessarily quit for good. Looking at more than a thousand people who wanted to quit, the authors found those who had more success quitting in the short term used e-cigarettes, but this effect was no longer observed at three- or six-month followups.

Something to keep in mind

Quitting smoking is considered one of the hardest bad health habits to break. The American Cancer Society cautions, «The truth is that quit smoking programs, other programs that treat addictions, often have fairly low success rates. But that doesn't mean they're not worthwhile or that you should be discouraged.»

If you do quit, it dramatically lowers your chances of getting lung cancer and many other types of cancer. It reduces your risk of heart disease and stroke significantly, and reduces your chances of getting other kind of lung problems. Smoking ages your skin and studies show an increasing number of people say they won't date smokers, so quitting can improve your social life, too.

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