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Nicotine Replacement Therapy in Pregnancy


Updated October 25, 2008

Prenatal Appointment
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Smoking in pregnancy has long been known to cause many problems for the pregnancy as well as the baby after birth. The problem was that smoking was so incredibly addictive making it difficult to quit smoking in general. In a general population using nicotine replacement therapy (NRT) improved the success of smoking cessation by 50-70% but the advice in pregnancy was to not allow pregnant women to use nicotine replacement therapy (NRT) often found in gum, patches, and other forms because of potential risks.

One study of over 87,000 women with singleton pregnancies, showed that smokers had a higher rate of stillbirth. It also showed that pregnant women who used nicotine replacement therapy, even if they did not quit smoking, had lower stillbirth rates than their smoking counterparts. It did not seem to matter which form of nicotine replacement was used. In a separate study, the use of nicotine gum didn't effect the quit rates but did increase the gestational age and birth weight.

If you are pregnant, or wish to become pregnant, please discuss quitting smoking with your doctor or midwife. They can help you with nicotine replacement therapy, counseling, education and support. There are even programs specifically designed for pregnancy.


Nicotine gum for pregnant smokers: a randomized controlled trial. Oncken C, Dornelas E, Greene J, Sankey H, Glasmann A, Feinn R, Kranzler HR. Obstet Gynecol. 2008 Oct;112(4):859-67.

Nicotine replacement therapy for smoking cessation. Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD000146.

Use of nicotine replacement therapy during pregnancy and stillbirth: a cohort study. Strandberg-Larsen K, Tinggaard M, Nybo Andersen AM, Olsen J, Grønbaek M. BJOG. 2008 Oct;115(11):1405-10. Epub 2008 Aug 20.

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