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Article
December 11, 1991

Nicotine Replacement Therapy During Pregnancy

Author Affiliations

From the Departments of Medicine, Psychiatry, and Pharmacy, University of California, San Francisco, and the Division of Clinical Pharmacology and Experimental Therapeutics, San Francisco General Hospital Medical Center.

From the Departments of Medicine, Psychiatry, and Pharmacy, University of California, San Francisco, and the Division of Clinical Pharmacology and Experimental Therapeutics, San Francisco General Hospital Medical Center.

JAMA. 1991;266(22):3174-3177. doi:10.1001/jama.1991.03470220090034
Abstract

CIGARETTE smoking is a major preventable cause of fetal death and injury, yet many women continue to smoke cigarettes throughout pregnancy. The most effective pharmacologic adjunct to smoking cessation therapy is nicotine replacement, including nicotine chewing gum or transdermal nicotine. However, the use of nicotine replacement therapy is contraindicated during pregnancy. The analysis presented herein suggests that the benefits of nicotine replacement therapy to aid smoking cessation in pregnant women who cannot stop smoking without such therapy substantially outweigh the risks of continued smoking or the risks of nicotine replacement per se.

PREVALENCE OF CIGARETTE SMOKING DURING PREGNANCY  Although the prevalence of smoking has declined in recent years and many women quit smoking when they become pregnant, 20% to 25% of pregnant American women continue to smoke throughout pregnancy; many of these women are heavy smokers. The National Health Interview survey of women pregnant in 1985 or with a birth

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