Smoking during pregnancy not only impacts on the woman's health but that of her unborn child. Women most likely to continue smoking throughout pregnancy are generally of lower age, socio-economic status, level of education and occupational status. Women who continue to smoke during pregnancy often feel criticized by society. They feel guilt and personal conflict at not quitting. Lack of long-term positive outcomes from anti-smoking campaigns may result form ignorance surrounding socio-economically disadvantaged women's life circumstances. Current interventions often ignore the emotional and psychological stressors associated with pregnancy; they do not address the altered physiological processes that occur during pregnancy. A review of the literature pertaining to women who smoke throughout pregnancy is presented. Women want an individualised approach to smoking cessation advice, with health care workers having knowledge of the woman's social situation and viewpoints. This paper reveals that the woman's perspective has largely been ignored. Indeed health care professionals have attempted to manipulate women to stop smoking rather than engage in mutually respectful dialogue.