Nicotine replacement therapy … - Carlos A ... - Entretiens du Carla

Recommendations
for clinical
practice
The evidence base for using of NRT in
pregnancy has not changed substantially
over the past decade and recommendations
made here are very similar to those in
current US and UK guidance.
1- All women who smoke should attempt
to stop smoking prior to conception.
Physicians should provide women with
evidence-based support in their preconception
attempt at achieving cessation.
2- If women fail to stop smoking before
becoming pregnant, they should be
encouraged to stop smoking as early as
possible in pregnancy, using only
behavioural support provided in addition to
(i.e. outside of) routine ante-natal and
medical care.
3- If a pregnant women cannot achieve
smoking cessation during pregnancy using
behavioural support only, clinicians should
discuss the risks and benefits of using NRT in
pregnancy. Caution needs to be exercised
with women who are light smokers and NRT
should not be suggested as an option for
women who smoke only occasionally.
4- Discussion of NRT must allow women
to make an informed decision about
whether or not to use this. Points which
should be covered are:
• the belief that NRT is safer than
smoking in pregnancy is based on theory
rather than hard evidence,
• although NRT helps non-pregnant
people to stop smoking, it has not been
shown to definitely help pregnant women
with smoking cessation,
• NRT contains one toxin that women
who smoke regularly and heavily (probably >
10 cigs per day before pregnancy) would
probably receive more of by their continued
smoking. However, the cigarette smoke that
they inhale would contain 3000 or more
other toxins too. ■
The working group - Welcome by J. Chevallet.
41 Recommendations during pregnancy - Tim Coleman