Smoking tobacco during pregnancy is associated with a number of pregnancy complications and range of poor foetal outcome. A number of barriers to achieving smoking cessation are emerged from three issue areas: pregnant women, health providers and organization. Pregnancy-specific barriers included lack of support, lack of knowledge and awareness about smoking harms. Health Providers (HPs) related barriers are lack of knowledge and awareness about NRT prescription, Credibility of HPs and at organization level weak polices and organizational frameworks are some of the barriers. Facilitators to NRT use in pregnancy are relationships with partners, family, friends and HPs, knowledge and awareness about NRT, organizational framework like stop smoking-cessation services (SSSs), Carbon monoxide (CO) monitoring and clear policies. Smoking-cessation treatment should consist to increase motivation to quit, help pregnant smokers to achieve abstinence and substitute behaviors are necessary for permanent abstinence.