by Jackie Hart, MD
Q: I am trying to quit smoking while I am pregnant. Is the nicotine patch or gum safe to use? If not, what are my other options?
A: Congratulations on your commitment to quit smoking! Giving up cigarettes will improve your health and the health of your baby. Pregnant women who smoke are more likely to have miscarriages and preterm labor. Also, babies born to smokers are often smaller than normal and may have more health problems, while children of smokers are prone to asthma and other respiratory disorders.
There have been only a few studies addressing the safety of a nicotine substitute, such as the patch, gum, or an inhaler (the latter is by prescription), for pregnant women. The results are not conclusive. In one study, a group of six women between 28 and 37 weeks of pregnancy were observed while on the patch for six hours. Although the women and their fetuses seemed to do okay during that short time, six hours is not long enough to determine the safety of the nicotine patch during pregnancy.
In another study, researchers measured the nicotine levels of 14 pregnant women after two different phases: smoking for eight hours and wearing the patch for eight hours. Nicotine levels were the same for each woman after both phases. However, there were signs (namely a diminished fetal heart rate) that the fetus was not doing as well when the mother was wearing the patch compared with when she was smoking.
It is difficult to draw definitive conclusions from these two small studies. But if you are pregnant and smoking one to two packs per day or more, and have been unable to quit using any other method, a nicotine substitute may be worth a try. Even though we dont know for sure that the medication is safe, when you smoke regularly, the fetus is being exposed to a dangerous amount of nicotine. Therefore, if you can quit successfully using any method, you and your baby will be better off. (Note: it is imperative that you DO NOT smoke when using a nicotine substitute.)
Behavior Modification
If you are not comfortable with the uncertainty of the safety of nicotine substitutes during pregnancy, you have other options, notably behavior modification. While such practices are now generally considered more mainstream than alternative, they are still a natural and complementary means to a healthful lifestyle. The following approach has been valuable in my clinical practice:
Once you have quit, these tips will help you be successful:
Q: I am trying to quit smoking while I am pregnant. Is the nicotine patch or gum safe to use? If not, what are my other options?
A: Congratulations on your commitment to quit smoking! Giving up cigarettes will improve your health and the health of your baby. Pregnant women who smoke are more likely to have miscarriages and preterm labor. Also, babies born to smokers are often smaller than normal and may have more health problems, while children of smokers are prone to asthma and other respiratory disorders.
There have been only a few studies addressing the safety of a nicotine substitute, such as the patch, gum, or an inhaler (the latter is by prescription), for pregnant women. The results are not conclusive. In one study, a group of six women between 28 and 37 weeks of pregnancy were observed while on the patch for six hours. Although the women and their fetuses seemed to do okay during that short time, six hours is not long enough to determine the safety of the nicotine patch during pregnancy.
In another study, researchers measured the nicotine levels of 14 pregnant women after two different phases: smoking for eight hours and wearing the patch for eight hours. Nicotine levels were the same for each woman after both phases. However, there were signs (namely a diminished fetal heart rate) that the fetus was not doing as well when the mother was wearing the patch compared with when she was smoking.
It is difficult to draw definitive conclusions from these two small studies. But if you are pregnant and smoking one to two packs per day or more, and have been unable to quit using any other method, a nicotine substitute may be worth a try. Even though we dont know for sure that the medication is safe, when you smoke regularly, the fetus is being exposed to a dangerous amount of nicotine. Therefore, if you can quit successfully using any method, you and your baby will be better off. (Note: it is imperative that you DO NOT smoke when using a nicotine substitute.)
Behavior Modification
If you are not comfortable with the uncertainty of the safety of nicotine substitutes during pregnancy, you have other options, notably behavior modification. While such practices are now generally considered more mainstream than alternative, they are still a natural and complementary means to a healthful lifestyle. The following approach has been valuable in my clinical practice:
- Set a quit date that is one to two weeks away; this gives you just enough time to get ready without time to talk yourself out of quitting.
- Tell your friends, family, and co-workers that you are going to quit on that day.
- Even before you pick the quit date, keep a smoking journal. This exercise will draw your attention to how much you smoke, and help you identify the habits you need to change. Develop substitutes for anything that triggers your desire to smoke. For example, if you smoke in the car, remove the ash trays and fill that space with potpourri or keep pretzels there so you can "pretend smoke" them. If drinking coffee gives you the urge to smoke, try tea instead. Also, clean your house and your clothes really well to rid them of the smell of smoke.
Your smoking journal should include: - Time of day that you smoke each cigarette; write it down at the time, do not leave it to your memory.
- What you are doing when you smoke (i.e., driving, drinking your morning coffee, socializing, etc.).
- What you are feeling as you smoke (i.e., happy, stressed, frustrated, etc.).
Once you have quit, these tips will help you be successful:
- Never accept a cigarette from another person.
- When you have the urge to smoke, change your surroundings. Go to a store to "buy cigarettes" rather than purchasing them from a vending machine; by the time you get to the store, the craving will have subsided.
- If you succumb to a craving and buy a pack, smoke one cigarette and throw the rest away.
- At a time when you would normally smoke or when a craving hits, go for a walk. The endorphins released during exercise help curb cravings and contribute to success in quitting.
- Put aside the money you would normally spend on cigarettes and treat yourself regularly to clothing or a night out. After six months to a year, you could go on a trip. The dollars add up very quickly! In fact, if you save for the next 18 years, you could probably send your baby to college. (Dont quote me on that, I didnt do the math.)