Pregnancy smoking cessation

General precautions for each medication that has been used for smoking cessation are listed in the sections describing each medication. All FDA-approved first-line medications for smoking cessation have a relatively good safety profile. Consensus opinions on the safety of the various medications for persons with cardiovascular disease, other medical conditions, and pregnancy are beyond the scope of this chapter but can be found elsewhere (Society for Research on Nicotine and Tobacco 2003). 

Briggs G, Freeman R, Yaffe S Drugs in Pregnancy and Lactation A Reference Guide to Maternal and Fetal Risk. Philadelphia, Lippincott, Williams Wilkins, 2002 Chengappa KN, Kambhampati R, Perkins K, et al Bupropion sustained release as a smoking cessation treatment in remitted depressed patients maintained on neatment with selective serotonin reuptake inhibitor antidepressants. J Clin Psychiatry 62 503—508, 2001... 

Assessment and reduction in the use of alcohol, tobacco, and other substances prior to pregnancy improve outcomes. For smoking cessation, behavioral interventions are preferred. Intermittent delivery formulations of nicotine replacement therapies are preferred over the patches. If patches are used, 16-hour patches are preferred over 24-hour patches. 

Dempsey DA, Benowitz NL (2001) Risks and benefits of nicotine to aid smoking cessation in pregnancy. Dmg Saf 24(4) 277-322... 

Some clinicians are hesitant to prescribe nicotine replacement therapy for smoking cessation during pregnancy because the safety and efficacy of nicotine replacement therapy has not been established in controlled clinical trials in this population. 

Benowitz NL, Dempsey DA, Goldenburg RL, et al. The use of pharmacotherapies for smoking cessation during pregnancy. Tobacco Control 2000 9(suppl3) S91-94. 

In the mid-twentieth century, pediatric care often began with a newborn examination shortly after birth. As of 2011, pediatric care often begins before conception. Women are advised via media sources or a health care provider to prepare for pregnancy and improve the chances for a healthy infant. This advice includes smoking cessation and supplementing the diet with folic acid, which decreases the incidence of neural tube defects, such as spina bifida. 

---