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Maternal smoking reduces uterine blood flow to the placenta, causing chronic placental hypoxia due to vasoconstriction.5961 It may also lead to villus hypoxia in early pregnancy62 and contribute to chorioallantoic haemorrhage and intervillous thrombus formation during pregnancies with placental abruption.63 Placental hypoxia and ischaemia resulting from smoking can increase antiangiogenic factors, decrease angiogenic factors and elevate inflammatory cytokines owing to increased oxidative stress, causing vascular endothelial dysfunction

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A comparison of the autonomy over tobacco scale and the Fagerstrm test for nicotine dependence