Do Nicotine Patches Work If You Are Pregnant?
Cigarette use during pregnancy is associated with a range of health problems that can lead to serious or severe complications before or after childbirth. For this reason, public health guidelines strongly urge women not to smoke while pregnant. In a study published in March 2014 in the journal BMJ (formerly known as the British Medical Journal), researchers from several French institutions sought to determine if nicotine replacement patches, one of the common options for smoking cessation treatment, produce any real-world benefit for pregnant smokers. These researchers concluded that nicotine patches don’t appear to work any better for pregnant women than placebo treatments.
Smoking During Pregnancy
Statistics compiled by the Centers for Disease Control and Prevention indicate that slightly over half (54 percent) of all women smokers suspend their cigarette use while pregnant. Still, significant numbers of women continue to smoke during the early, middle or late stages of pregnancy or throughout all stages of pregnancy. Known harms of fetal exposure to the chemicals in cigarette smoke include heightened risks for a pregnancy-ending miscarriage, heightened risks for delivering a baby prematurely, heightened risks for delivering a baby lacking in sufficient body weight, heightened risks for delivering a baby affected by one of several specific birth defects and heightened risks for delivering a child who will eventually die from sudden infant death syndrome (SIDS). In addition to the problems associated with direct exposure to cigarette smoke, developing children also have increased chances of being born underweight when exposed to secondhand smoke.
Nicotine Patches And Pregnancy
Like other nicotine replacement therapy products (such as gum, nasal sprays, inhalers and lozenges), nicotine patches produce their benefits by delivering preset, relatively small amounts of nicotine into the bloodstreams of people affected by nicotine addiction. These nicotine doses allow a person to curb his or her cigarette intake while avoiding the onset of the withdrawal symptoms that commonly afflict individuals trying to quit smoking and interfere with successful smoking cessation. Some smokers try to quit with the help of low-strength, non-prescription nicotine patches that are available at all sorts of commercial outlets throughout the U.S. Others rely on stronger nicotine patches that require a doctor’s prescription. In some cases, nicotine replacement therapy forms the entirety of a smoking cessation strategy. In other cases, nicotine replacement forms part of a larger approach that also includes some form of counseling, brief training or behavioral therapy training.
Effectiveness Of Nicotine Patches For Pregnant Women
In the study published in BMJ, the French research team used information gathered from 402 pregnant women to assess the effectiveness of nicotine patches as a deterrent to cigarette use. These women, all of whom were over the age of 18 and in the second trimester of pregnancy, came from 23 French hospitals and had a daily nicotine intake of five or more cigarettes. Half (203) of the study participants received nicotine patches, while the other half received placebo patches that mimicked the appearance of nicotine patches. Both groups continued to use their respective patches until they delivered their babies at the end of pregnancy.
The researchers used several criteria to compare the effectiveness of the nicotine patches to the placebo patches. The main criteria for each woman were successful abstention from cigarette use and the delivery of a child with normal birth weight. Secondary criteria included the overall number of women in each group who remained cigarette-free and the time it took for any given woman to relapse back into cigarette use.
Only 11 women in the nicotine patch group remained abstinent from cigarette use over the course of the study; a nearly identical number of women (10) in the placebo group also remained entirely cigarette-free. In both groups, the average woman relapsed back into cigarette use after a period of 15 days. In addition, when compared to the babies born to the women who used a placebo medication, the babies born to the women who received nicotine patches were, on average, only heavier at birth by about 1.8 ounces.
During part of the study published in BMJ, the researchers increased the nicotine patch doses until these doses reached or exceeded the amount of nicotine the women normally consumed while smoking. Even this increase in medically supplied nicotine did not improve smoking abstinence or delay the average time to smoking relapse. The study’s authors concluded that nicotine patches, in particular, do not appear to provide any benefit as a smoking deterrent to women during pregnancy. Pregnant smokers should discuss all possible treatment options with their doctors.