Editorials

Helping pregnant smokers to quit

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g1808 (Published 11 March 2014) Cite this as: BMJ 2014;348:g1808
  1. Leonie S Brose, lecturer in addictions
  1. 1UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, King’s College London
  1. leonie.brose{at}kcl.ac.uk

Behavioural support works, evidence on drug treatment still patchy

Although most smokers manage to quit during pregnancy, a proportion does not. In England, 26% of women smoke in the year before their pregnancy and 12% smoke through to delivery.1 The rate is similar in other high income countries, whereas in low and middle income countries, smoking rates are more variable and seem to be increasing among young women.2 In addition to the countless negative consequences for the smoker’s own mental and physical health, smoking in pregnancy is linked to a wide range of poor health outcomes for the child.3 Thus there is an urgent need to help pregnant smokers who find it difficult to quit.

Nicotine replacement therapy (NRT) is clearly effective in smokers in general,4 but a recent review of randomised controlled trials found no good evidence in pregnant women.5 In the linked paper, Berlin and colleagues (doi:10.1136/bmj.g1622) report a welcome randomised placebo controlled trial that found no benefit of transdermal nicotine patches in pregnant smokers.6 Recruitment seems to have been slow, but with over 400 participants this is the second largest trial of NRT …

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