Is it safe to use smoking cessation therapeutics during pregnancy?

  title={Is it safe to use smoking cessation therapeutics during pregnancy?},
  author={Nicole E De Long and Nicole G Barra and Daniel Barry Hardy and Alison C. Holloway},
  journal={Expert Opinion on Drug Safety},
  pages={1721 - 1731}
Introduction: Worldwide, 10 to 35% of pregnant women smoke. It is clear that smoking cessation has positive impacts for both the mother and child, yet many women are still unable to quit due to the addictive properties of nicotine. There are limited data surrounding their safety and efficacy in pregnancy. Areas covered: This review highlights evidence from clinical studies and animal experiments regarding the effects of smoking cessation therapeutics on pregnancy, neonatal and long-term… 

Success of smoking cessation interventions during pregnancy.

Nicotine Replacement Therapy during Pregnancy and Child Health Outcomes: A Systematic Review

Well-designed controlled clinical trials with sufficient follows-up are needed to provide more information on the use of NRT or other pharmacotherapies for smoking cessation during pregnancy on post-natal child health outcomes.

Adverse effects of perinatal nicotine exposure on reproductive outcomes.

This paper critically review the current knowledge from human and animal studies regarding the direct and indirect effects of maternal nicotine exposure, regardless of its source, on reproductive outcomes in pregnancy and postnatal life and highlights several key cellular mechanisms involved in these adverse reproductive deficits.

The use of electronic nicotine delivery systems during pregnancy and the reproductive outcomes: A systematic review of the literature

No studies of pregnant women exposed to ENDS use and its effect on their fetus or neonates are found and systematic reviews and meta-analysis of studies of women who used smokeless tobacco during pregnancy suggest that prenatal nicotine alone is a risk factor for low birth weight, premature delivery, and stillbirth.

Tobacco and Pituri Use in Pregnancy: A Protocol for Measuring Maternal and Perinatal Exposure and Outcomes in Central Australian Aboriginal Women

This is the first study to correlate the pregnancy outcomes of central Australian Aboriginal women with different tobacco exposures and the findings will provide the foundation for epidemiological data collection in related studies.

Clinician factors associated with prescribing nicotine replacement therapy in pregnancy: A cross‐sectional survey of Australian obstetricians and general practitioners

Clear guidance regarding safety and efficacy, with practical clinical protocols, are required in order to reduce variation in prescribing rates across these clinicians.

How to Choose the Medications for Treating Nicotine Dependence

The first line therapies for the treatment of nicotine dependence are nicotine replacement therapy (NRT), bupropion or varenicline, which are applied to smokers who have failed previous cessation attempts.

Nutritional Epidemiology of Antenatal Smoking Cessation Among Japanese Women

In conclusion, antenatal quitters are more likely to have a poor nutritional status before pregnancy than never-smokers, and having a good nutritional profile during the trimester may not sufficiently reverse the adverse effects of former smoking behaviors on pregnancy outcomes.



Nicotine replacement therapy during pregnancy

Pharmacotherapy for smoking cessation during pregnancy.

  • N. BenowitzD. Dempsey
  • Medicine
    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
  • 2004
The safety of pharmacotherapy is the key question that needs to be resolved before the authors progress in enhancing smoking cessation during pregnancy, and the risks associated with medications that might result in a woman quitting are focused on.

Pharmacological interventions for promoting smoking cessation during pregnancy.

The primary efficacy outcome was smoking cessation in later pregnancy (in all but one trial, at or around delivery); safety was assessed by seven birth outcomes that indicated neonatal well being and there were no trials of varenicline or bupropion.

Effectiveness of Bupropion for Smoking Cessation During Pregnancy

Bupropion appears to be effective for smoking cessation therapy during pregnancy in pregnant smokers, in a prospective matched, controlled observational study.

The pharmacotherapy of smoking cessation

All forms of nicotine replacement therapy (NRT) — gum, patches and inhaler — and bupropion are safe and effective for increasing smoking cessation rates in the short and long terms.

Postnatal Metabolic and Reproductive Consequences of Fetal and Neonatal Exposure to the Smoking Cessation Drug Bupropion

Fetal and neonatal exposure to the smoking cessation drug bupropion, unlike NRT, does not appear to adversely affect metabolic outcomes or the fertility of the female offspring, however, buPropion does appear to alter pubertal onset through an as yet unknown mechanism.

Efficacy and safety of nicotine replacement therapy for smoking cessation in pregnancy: systematic review and meta-analysis.

There is currently insufficient evidence to determine whether or not nicotine replacement therapy is effective or safe when used in pregnancy for smoking cessation; further research and, in particular, placebo-randomized controlled trials are required.

Association between nicotine replacement therapy use in pregnancy and smoking cessation.

A randomized trial of nicotine-replacement therapy patches in pregnancy.

Adding a nicotine patch to behavioral cessation support for women who smoked during pregnancy did not significantly increase the rate of abstinence from smoking until delivery or the risk of adverse pregnancy or birth outcomes, however, low compliance rates substantially limited the assessment of safety.

Comparison of Cotinine Levels in Pregnant Women While Smoking and When Using Nicotine Replacement Therapy

Cotinine levels generated using NRT during pregnancy were lower than levels achieved from smoking, consistent with the hypothesis that NRT patches deliver an inadequate dose of nicotine to aid smoking cessation during pregnancy.