Nicotine patches do not appear to help pregnant smokers to quit

March 11, 2014, British Medical Journal

Smoking during pregnancy increases the risk of adverse pregnancy and birth outcomes and may have long lasting effects in offspring.

In England, 26% of women smoke in the year before their pregnancy and 12% smoke through to delivery. The rate is similar or even higher in other high income countries.

Guidelines suggest adding nicotine replacement therapies (NRT) to behavioural cessation support in because of their excellent safety profile and proved effectiveness in other groups of smokers. However, there is a lack of good quality evidence on the effectiveness of NRT in pregnant smokers.

So a team of researchers based in France set out to assess the efficacy of 16 hour nicotine patches among 402 pregnant women aged over 18 years and between 12 and 20 weeks' gestation, who smoked at least five cigarettes a day.

Participants were randomised to receive either nicotine patches or placebo patches up to the time of delivery. Doses were individually adjusted to try to match participants' nicotine intake to that achieved by smoking.

Participants were assessed monthly and received behavioural support. The primary outcome measures were complete abstinence (confirmed by levels of carbon monoxide in expired air) and birth weight.

Nicotine patches offered no benefit over placebo in terms of increasing smoking cessation or birth weight.

Complete abstinence was achieved by only 11 (5.5%) of women in the nicotine patch group and only 10 (5.1%) in the placebo patch group. The average time to the first cigarette smoked after target quit date was 15 days in both groups.

Average birth weight was 3065g in the nicotine patch group and 3015g in the placebo patch group.

Blood pressure was significantly higher with the than with placebo, suggesting that further studies with in pregnant smokers should control for blood pressure, they add.

"These are disappointing results and should encourage efforts to evaluate new approaches that are both drug and non-drug related," conclude the authors. "In the absence of evidence based drug interventions, behavioural support remains the core intervention to help pregnant smokers to quit."

In an accompanying editorial, Leonie Brose at the Institute of Psychiatry, King's College London, points to the delay in behavioural support in the first two weeks of the study, and suggests this may explain why both groups had low success rates.

However, she says, in contrast with disappointing results and a slim evidence base for drug treatment, good evidence shows that psychological interventions help pregnant smokers to quit.

"It may be too early to abandon the option of NRT entirely," she writes. "However, a much greater effort is still needed to identify, test, and deliver more effective treatments for pregnant smokers who struggle to quit."

Explore further: Stronger nicotine dependence correlates with higher post-smoking weight gain

More information: www.bmj.com/cgi/doi/10.1136/bmj.g1622
www.bmj.com/cgi/doi/10.1136/bmj.g1808

Related Stories

Stronger nicotine dependence correlates with higher post-smoking weight gain

August 21, 2013
Smokers with more severe nicotine dependence are more likely to gain weight when they try to quit, according to research published August 21 in the open access journal PLOS ONE by Koji Hasegawa and colleagues from Kyoto Medical ...

Study finds that smokers who try e-cigarettes to quit are younger and more motivated to quit

July 23, 2013
University of Hawaii Cancer Center Prevention and Control Program researchers Pallav Pokhrel, PhD and Thaddeus Herzog, PhD have found that smokers who use e-cigarettes as a tool to stop smoking tend to be younger and more ...

Nicotine patches may not help during pregnancy

March 1, 2012
(HealthDay) -- Nicotine patches don't seem to be of much use in helping pregnant women quit smoking, a new study finds.

Fetal exposure to nicotine increases long-term risk of obesity

January 16, 2014
Many women are encouraged to quit smoking when they become pregnant using nicotine replacement therapy (NRT) whether as gum, transdermal patches, nasal spray or lozenges. But new research from Western University in London, ...

Want to stop smoking? See a specialist

December 20, 2013
Smokers in England who want to stop smoking are three times more likely to succeed if they see a trained advisor than if they try by themselves, according to a new study published online today in the medical journal Addiction. ...

First trial to compare e-cigarettes with nicotine patches shows comparable success in helping smokers to quit

September 7, 2013
The first ever clinical trial to compare e-cigarettes with nicotine patches has found that both methods result in comparable success in quitting, with roughly similar proportions of smokers who used either method remaining ...

Recommended for you

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

Your dishwasher is not as sterile as you think

January 13, 2018
(HealthDay)—Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.

Study reveals what sleep talkers have to say

January 12, 2018
A team of researchers with members from several institutions in France has conducted a study regarding sleep talking and has found that most sleep talking is not only negative in nature, but involves a large amount of swearing. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.