INTRODUCTION: The objective of this study was to assess smoking cessation and reduction patterns among pregnant smokers. One in ten women in the United States will continue to smoke during their pregnancy. Smoking continuation during pregnancy is one of the most preventable causes of negative health outcomes for both the mother and baby. METHODS: We used data from a prior study of 468 pregnant patients. In this study, participants self-identified as tobacco smokers during the visit. Data was abstracted from all obstetrics visit(s) to assess cessation or continuation of smoking. For patients who reported quitting, we noted gestational age when quit was first documented. We also assessed whether cessation was sustained through documentation in subsequent progress notes. We performed descriptive statistics using SPSS. RESULTS: From 468 total study patients, 167 patients (36%) admitted to smoking tobacco during the first obstetric visits. Fifty-three (31.7%) patients quit during their pregnancy. Of these 53 patients, 41.5% quit during the first trimester, 47.2% during the second trimester, and 11.3% during the third trimester. Additionally, 11 of the 53 (20.8%) had remained quit at their postpartum visit where 4 of the 53 (7.5%) claimed to have started smoking again postpartum. The remaining 38 (72%) either did not come to their postpartum visit or were not asked about their smoking status at the visit. CONCLUSION: Less than a third of pregnant smokers quit smoking during their pregnancy. Those that quit were more likely to do so earlier in the pregnancy. Efforts for smoking cessation should target early pregnancy visits.