Smoking during pregnancy is hazardous to both the mother and the fetus, according to a substantial amount of recorded data. Exposure to nicotine and other compounds in cigarette smoke increases the risk of sudden infant death syndrome (SIDS) by two to five times during pregnancy. Serotonergic abnormalities have been discovered in SIDS infants in the zone of the medulla oblongata, which is known to control cardio-respiratory function. SIDS establishes a connection between depression, learning difficulties, and behavioral disorders. Prenatal nicotine intake during the second trimester affects the dopaminergic neurological system, making the fetal brain more susceptible to nicotine and developing ADHD symptoms not just in a fetus, but in adolescents also. Prenatal nicotine exposure alters the neurological route of neurotransmitters, acetylcholine, and dopamine. Nicotine enhances neuronal activity in adults but desensitizes these processes in babies and young children exposed prenatally. The impact of a neurotoxin like nicotine is determined by the amount and duration of exposure. Continued exposure throughout pregnancy will influence a wide range of activities in the neurodevelopment, whereas exposure confined to a single stage of pregnancy may only affect the processes that are forming at that stage. To decrease the effect of nicotine on neonates due to maternal smoking strategies like nicotine replacement therapy (NRT), folic acid treatment and other behavioral treatments have been studied. Hence, this review focuses on the impact of exposure to nicotine on neonates which results in various neurological consequences and smoking cessation therapies.