Nicotine Replacement Therapy (NRT)

Date: July 2018, Version 1

Why should I stop smoking if I’m pregnant?

There is strong evidence that smoking during pregnancy increases the chance of miscarriage, certain birth defects (including cleft lip and palate), premature birth, and poor growth of the baby in the womb, which has been linked to certain health problems later in life.

Ideally it is better to have given up smoking before pregnancy. However, research shows that stopping smoking or cutting down significantly in early pregnancy can reduce the likelihood of the baby having some of the health problems linked to smoking.

If you want to stop smoking, your doctor or midwife will be able to help.

What is nicotine replacement therapy?

Nicotine is highly addictive and stopping smoking often causes withdrawal symptoms that can be difficult to manage. Nicotine replacement products such as patches, chewing gum, mouth spray, nasal spray and lozenges (Nicorette®, NiQuitin®, Nicotinell®) provide a controlled dose of nicotine that can help to control withdrawal symptoms when stopping smoking. Use of these products can then gradually be reduced until the body is ‘weaned off’ nicotine.

What about e-cigarettes (vaping)?

E-cigarettes contain nicotine and flavouring, as well as a number of other chemicals. No studies have been carried out to investigate whether vaping in pregnancy can harm the baby. However, many healthcare professionals believe that vaping exposes the baby to fewer toxic chemicals than smoking. Vaping may therefore be an option for pregnant women who cannot stop smoking using other nicotine replacement products.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

Use of nicotine replacement therapy during pregnancy would not normally require extra monitoring of the baby, although women who have smoked heavily in pregnancy may be offered additional monitoring of their baby’s growth.

Are there any risks to my baby if the father used nicotine replacement therapy?

We would not expect any increased risk to your baby if the father used nicotine replacement therapy before or around the time you became pregnant.

Who can I talk to if I have questions?

Pregnant women who smoke can contact the NHS Pregnancy Smoking Helpline for further information (Tel: 0800 169 9169).

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.