Can You Be a Surrogate If You Smoke or Use Marijuana?

Smoking, vaping and cannabis are some of the most common things women ask about before they apply, and the answer depends a lot on whether we're talking about now or the past. Here's how screening handles each, and why.

Published October 19, 2026

In most programs, not while you're currently smoking, vaping or using marijuana - ASRM's screening guidance includes a urine drug screen, and agencies and clinics typically expect you to be nicotine-free and cannabis-free before you start and throughout the pregnancy. Past use is a different question, and women who stopped well before applying, or who used only occasionally, can often still qualify depending on the program.

I want to be direct about this one, because it's a question a lot of women are nervous to ask. Using nicotine or cannabis doesn't make you a bad candidate as a person. It's simply something every program screens for, because a surrogate pregnancy is carried for someone else, and everyone involved has agreed to give that baby the healthiest start they can. Here's how it works, and what you can do if this is the thing standing between you and applying.

Why programs care

The concern is the pregnancy itself. Medical organizations are consistent that tobacco and cannabis carry real risks during pregnancy:

• Smoking and vaping. The American Academy of Family Physicians notes that smoking can raise the risk of miscarriage, preterm birth, low birth weight and certain birth defects, and has been linked to sudden infant death syndrome. It treats e-cigarettes as tobacco products with the same concerns, and its advice is to avoid tobacco in any form throughout pregnancy.
• Marijuana. ACOG recommends that women who are pregnant or contemplating pregnancy be encouraged to discontinue marijuana use. A 2025 review of 51 studies linked cannabis use in pregnancy with higher rates of preterm birth, low birth weight and infant death.

A surrogate is, by definition, someone contemplating pregnancy. So the medical answer and the program answer line up.

What ASRM's screening includes

ASRM's recommendations for practices using gestational carriers build substance use into screening in a few places:

• Your history. The psychological evaluation includes a substance use history, which ASRM describes as including "tobacco, alcohol, marijuana, recreational drugs, prescription drugs."
• A urine drug screen. It's listed among the preconception tests a carrier has before she's accepted, alongside things like blood type and immunity checks. Our guide to what happens at your medical screening walks through the rest.
• Lifestyle expectations. ASRM says expectations about alcohol, tobacco use and other lifestyle choices should be discussed with you and your partner in counseling, and expectations for your behavior during the pregnancy come up again in the joint session with the intended parents.

ASRM's criteria for declining a carrier include "unresolved or untreated alcohol and/or drug abuse or addiction." How that criterion applies to you is a judgment the mental health professional and clinic make after your evaluation. On top of it, each agency and clinic sets its own policy on nicotine and cannabis use, which is why answers can differ between programs.

Current use vs. past use

This is the distinction that matters most.

If you use now

Most agencies and clinics won't move forward while you're currently smoking, vaping or using cannabis, even if you plan to stop once you're matched. Programs generally want to see that you've already stopped before screening, and they expect you to stay nicotine-free and cannabis-free from medications through delivery. Some programs ask for a set nicotine-free or cannabis-free period before you apply, and the length varies by agency and clinic.

If you used in the past

Occasional use years ago is usually not a barrier. Heavier or more recent use is looked at case by case, often alongside the psychological evaluation. Intended parents also see parts of your profile, and some are more comfortable with past use than others. If you quit smoking, vaping or cannabis on your own and have stayed quit, say so plainly. That's a strength in a screening conversation, not something to hide.

"But it's legal where I live"

Recreational or medical cannabis being legal in your state doesn't change program policy. State law decides whether you can buy it, not whether an agency or clinic will start a surrogacy cycle with you while you use it.

If you use cannabis for a medical reason, like sleep, pain, nausea or anxiety, that's worth raising honestly. ACOG recommends that women using marijuana for medicinal purposes be encouraged to switch to an alternative therapy with better pregnancy-specific safety data. That's a conversation for your own doctor, and the screening team will want to understand what the cannabis was helping with as well as the use itself. Never stop or change a medication on your own.

What about your partner and household?

Secondhand smoke is also something to avoid during pregnancy. Programs typically ask about smoking in your home, and some ask that no one smoke around you or inside the home during the journey. ASRM also recommends infectious disease testing for your partner and includes your partner in the psychological evaluation, so expect the household as a whole to be part of the conversation, not just you.

Be honest, because screening will ask anyway

Between the medical history, the urine drug screen and the psychological evaluation, substance use comes up more than once. Some programs also test for nicotine specifically. Being upfront from the start saves you a disappointing surprise later, and it builds trust with the people deciding on your application. If it turns out a program wants you to wait, you'll know exactly how long and what to do next.

Where Borne fits

Our questionnaire asks about your health and habits so we can point you toward programs where you're likely to be a fit. If you've quit, we'll talk about how long ago and what the agencies we work with tend to look for. If you're still using, we'll tell you honestly that it's a "not yet," and what it would take to change that. A "not yet" isn't a "no."