Purpose of Review <p>Systematic review to identify the most promising experimental approaches to modify prenatal alcohol and cigarette use published since 2019.</p> Recent Findings <p>20 studies met review criteria. Among the five approaches to prenatal alcohol use, a study comparing brief intervention or brief advice to treatment as usual in Argentina, and a practice change intervention to include evidence-based assessment and intervention of prenatal alcohol use in Australia were noteworthy. Five different strategies to modify cigarette use included diverse samples and settings. An innovative approach that was rigorously evaluated was conducted in Hong Kong where an intervention with brief advice, a nicotine sample, and active referral to smoking cessation service resulted in doubling the odds of biochemically validated abstinence from nicotine in expectant fathers when compared to an attention control condition.</p> Summary <p>Prenatal alcohol and cigarette smoking are common in the US and pending effective intervention strategies that may be informed by international research.</p>