Nicotine Replacement Therapy (NRT)

(Date: July 2018. Version: 1)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

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 thr 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).

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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