The 2014 Surgeon General's report is the 32nd tobacco-related report since 1964. While focusing on 50 years of tobacco control and prevention, one of the published articles detailed how smoking in early pregnancy can cause orofacial clefts in babies.

Orofacial clefts, also considered 'cleft lips' and 'cleft palates', are birth defects that occur when a baby's lip or mouth do not form properly during pregnancy. Cleft lips occur if the tissue that makes up the lip does not completely join before the child is born. This tissue forms between the fourth and seventh weeks of pregnancy. Similarly, a cleft palate, or the roof of the mouth, occurs if the tissue does not completely join before birth, which forms between the sixth and ninth weeks of pregnancy.

A new feature released by the Centers for Disease Control and Prevention highlights the Surgeon General's analysis about how smoking in early pregnancy can cause these orofacial clefts. Over 400 babies each year are born with such clefts, and 6% of those born with them are caused by a woman smoking in early pregnancy. Eliminating these defects, which require a number of surgeries, would save the United States over $40 million in health care costs. Orofacial clefts are more common in babies whose mothers who smoke during pregnancy, have diabetes, and those who take certain medicines for epilepsy.

However, the cause for these clefts are unknown. It is believed they occur in some babies due to a change in their genes, along with what the mother comes into contact with, eats, and/or drinks during her pregnancy. Children who suffer from a cleft lip or palate can experience problems with their ears (hearing issues and ear infections), their teeth, feeding, speaking clearly, and others based on the severity of the deformity. As a result, the Surgeon General urges pregnant women to avoid smoking cigarettes as well as others who might be smoking around them.

The article, "Prevention of orofacial clefts caused by smoking: Implications of the Surgeon General's report," was published in the journal Birth Defects Research Part A: Clinical and Molecular Teratology. The researchers used published data from the Pregnancy Risk Assessment Monitoring System in 27 states on women reporting smoking just before pregnancy. They then estimated a woman's smoking prevalence in the first few weeks of pregnancy and before pregnancy is recognized. Numbers from 2010 found that 23.2% of women smoked just before pregnancy.

Orofacial clefts aren't the only birth defect as a result of smoking during pregnancy. The report notes that others include premature birth, some heart defects, and Sudden Infant Death Syndrome (SIDS). Cigarette smoking has implications for everybody, as the Surgeon General's report also found that more than 20 million Americans have died since the first smoking report was published in 1964.

You can read more about the report on the Surgeon General's website.