Nicotine patches for pregnant women

There is evidence that the patch improves the chances of people quit smoking, but researchers have not found the same benefits for pregnant women.

Nicotine patches do not help pregnant women quit smoking, suggests a new study from the UK – partly because so few women use them for other purposes.
Although there is evidence that raises the chances of a patch, most people will be able to get rid of this habit, the researchers did not find the same benefits for pregnant women.

“I do not think this is a question as to how nicotine patch works. Big problem is that people are going to use it and join it,” said Dr. Gideon Koren, head of the Motherisk program at the hospital for Sick Children in Toronto, who was not involved in the new report.
No additional consultations to encourage women to stick to their plan to quit, he told Reuters Health, “a typical attempt is likely to fail.”

Pregnant women may be further may refuse to upgrade because of an increase in metabolism, women’s bodies handle nicotine patch is much faster than they otherwise would have – which makes treatment less effective in reducing cravings and withdrawal symptoms.
The good news, researchers say, is that nicotine replacement therapy does not seem to increase risk of miscarriage or stillbirth or cause a child to be born any earlier or lighter.

This means that experiments with higher-dose nicotine patch may be the next step, according to Dr Tim Coleman of the University of Nottingham and his colleagues.
In the study, researcher’s randomly assigned more than 1,000 pregnant British smokers are usually in the second trimester of pregnancy, use of nicotine patch or an identical drug-free “placebo” patch for two months.

The women initially were personally advising session, and then on the phone returns on their cigarettes.
During the first month of treatment, 21 percent of women in the nicotine patch quit smoking, compared with less than 12 percent of drug-free patches.
However, only nine percent of women in the nicotine patch and eight percent in the placebo group continued smoking by the time they were delivered – a distinction which may be due to chance.

Low commitment to
Team Coleman found that only seven percent of women using nicotine patches consistently for more than a month, and three per cent continued to use drug-free patches after one month of departure
“It’s really hard to help pregnant women stop smoking when they do not take care,” said Kathryn Pollak, who has studied smoking in the Duke University Medical Center in Durham, North Carolina.

This is not due to lack of drive, said Pollack, who was not involved in the new study. But women who had quit as soon as they find out they are pregnant, likely, those who rely on cigarettes and need lots of help in this process, she said.
Because nicotine is eliminated from the body much faster by the end of pregnancy, Pollack said that this study may be an example of “under dosing”, and that the nicotine patch in the standard may not work well enough to help women to avoid cigarette without suffering from withdrawal.
But some researchers fear driving the dose is too high, because of possible effects on the fetus.
“We must be very careful about how much we give of nicotine,” Pollack said Reuters Health. “We have to find that fine line, enough to help, but not too much.”
In a study in the UK, there is no evidence in the higher risk of birth defects, premature birth and other pregnancy complications in women assigned to nicotine patch, the researchers reported Wednesday in The New England Journal of Medicine.

Koren said that even at a dose used in the study – 15 mg over 16 hours – a patch can help women who also receive regular face to face consultation.
Psychotherapy is the typical treatment that doctors recommend that pregnant women trying to quit, partly because of a drug-free.

“Stick it”
Nicotine patches are usually run about $ 2 a day and you can buy without a prescription.
The study, which was funded by National Institutes of Health Research in the UK, does not mean that it’s time to give up nicotine replacement therapy completely, researchers said.
“Outside of pregnancy (patch) seems to work even at a dose we used very effectively, even with minimal behavioral support,” Coleman told Reuters Health.

“If you are planning a pregnancy, try the more difficult to use any drugs that are available before you get pregnant,” because then it may be that much harder to quit, he advised.
Pollack said that pregnant women may benefit from nicotine replacement – as long as they do not refuse it.
“Talk to your doctor about the costs and benefits, and know that nicotine replacement works only when you do so at the time it is written,” she said.
“You just kind of have to stick to it

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