Nicotine patches don’€™t really help in pregnancy

In the study, researchers from the Centre of Tobacco Control Studies at the University of Nottingham in England divided 1 050 women who were 12 to 24 weeks pregnant into two groups: one receiving behavioural smoking cessation support and nicotine patches, and the other also received counselling, but the patch they received contained no nicotine, although it looked similar to the original.

During the first month of the study, the women who received the active nicotine patch had higher quit rates (about 21%) than the placebo group (nearly 12%). But by the time the women delivered their babies, the quit rates for both the groups were similar ‘€“ 9.4% for those wearing the real patch and 7.6% for those wearing the placebo. The 1.8% difference is not considered to be statistically significant.

“The nicotine patch improved short-term but not long-term quit rates,” said Dr Cheryl Oncken, a professor of medicine, obstetrics and gynaecology at the University of Connecticut School of Medicine in Farmington in the United States, who wrote an accompanying editorial.

The authors noted a possible reason is that many of the women stopped wearing the patches. Just over 7% of women assigned to the nicotine-patch and fewer than 3% than those assigned the placebo used the patch for more than a month.

Safety concerns

Smoking during pregnancy is associated with low birth-weight babies, which can impact the infant’€™s growth and development throughout life. Smoking has also been associated with miscarriage, stillbirth and sudden infant death syndrome.

Nicotine replacement in pregnant women is not recommended by the US Centres of Disease Control and prevention, and is typically used as a last resort when pregnant women can’€™t quit on their own or with counselling.

According to Dan Jacobsen, a nurse practitioner at the US Centre for Tobacco Control, there are safety concerns about the use of nicotine replacement in pregnancy, as the nicotine itself affects the foetus. A study, published in an upcoming issue of the journal Pediatrics, Dutch researchers found that exposure to nicotine ‘€“ either from cigarettes or nicotine replacement therapy ‘€“ was associated with a significantly increased risk of colic. Babies with colic cries excessively and inconsolably for at least three hours a day, more than three days a week, for more than three weeks.

For her part, Oncken said, it would be useful to know whether women in the study started smoking again, and then quit using the patch; or if they quit using the patch and then started smoking again. Knowing which came first would help determine whether future smoking-cessation efforts should focus on encouraging women to continue to use nicotine replacement therapy, or that the medication itself (the nicotine) just doesn’t help pregnant women alleviate the urge to smoke.

Either way, Jacobsen said, “nicotine replacement doesn’t seem to be the answer for pregnant women. In certain patients, maybe. But we need to work with them individually to try to help them quit.”

Source: HealthDay News

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