Introduction: Tobacco use during pregnancy is a major public health concern due to the risks it poses to the health of the unborn child. While the prevalence of smoking during pregnancy is well known, little is known about smokers’ knowledge and perceptions regarding the risks they face, the importance of smoking during breastfeeding, or pregnant women’s exposure to secondhand smoke. Method: A telephone survey was conducted in 2012 among a national sample of 3,603 pregnant women or women who had recently given birth. Results: Daily tobacco use in the past month was reported by 16.1% of pregnant women and 13.4% of breastfeeding mothers. Among working women, 10.2% reported being exposed to secondhand smoke at their workplace. Just under half of the women affected (49.4%) received workplace accommodations during their pregnancy. When asked about the nature of the risks involved, both smokers and nonsmokers spontaneously mentioned possible “respiratory problems” for the child first. For 78.2% of smokers, the “stress” caused by quitting smoking would be more harmful to the child than moderate tobacco use. For more than half of the smokers (53.8%), nicotine replacement therapy (NRT) was believed to be discouraged during pregnancy. Conclusion: The results highlight the need to improve women’s knowledge of the risks associated with smoking and the options available to help them quit during pregnancy.