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Introduction: Cigarette smoking amongst pregnant adolescents is a preventable risk factor associated with low birthweight (<2,500 g), preterm birth (<37 weeks) and infant mortality. The aim of this study was to compare birth outcomes of adolescents who smoke during pregnancy with those who do not and to construct their birthweight-for-gestational-age curves., Methods: A retrospective cohort analysis of 534 adolescents (10 cigarettes daily had babies with larger birthweight reduction (P = 0.001)., Conclusion: Almost half of all adolescents smoked during their pregnancy. Birthweight-for-gestational-age curves of smoking adolescents showed a marked fall-off in weight from 36 weeks of gestation, and at least 10% of adolescent smokers showed fetal growth restriction from before 32 weeks of gestation.