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Smoking during pregnancy increases the risk for maternal and fetal adverse events including gestational hypertension, intrauterine growth restriction, low birth weight and sudden infant death syndrome. It is recommended that clinicians should discuss and prescribe smoking cessation programs to pregnant patients. In this review, the effectiveness of potential interventions including cognitive behavioral therapy (CBT) and nicotine replacement therapy (NRT) are examined and compared to the potential of exercise-aided smoking cessation programs. There is limited research available to confidently conclude that CBT on its own is an effective approach to reducing smoking during pregnancy. NRT has shown some success in reducing the total number of cigarettes smoked however the low dose of nicotine made available through NRT still poses as a risk to the developing fetus. Exercise has shown to have an acute effect on decreasing cravings and withdrawal symptoms, however there is limited research conducted for long-term cessation programs. This review provides information regarding the current gaps in literature that need to be addressed in order to confidently determine the effect exercise may have on smoking cessation during pregnancy. Additionally, the role of physicians in promoting and prescribing exercise is discussed.