Should pregnant patients use smoking cessation meds?

Data on smoking cessation medication use in pregnancy are sparse and safety of the drugs in pregnancy is unknown, but smoking threatens the fetus, so clinical practice guidelines note that it may be safer to use these medications in pregnancy rather than continue smoking. An article in the February issue of Obstetrics and Gynecology concludes that pregnant women are more likely to take smoking cessation drugs if their obstetrician discusses the drugs with them and if they have private health insurance.

Nancy A. Rigotti, MD, and colleagues at the Massachusetts General Hospital and Harvard Medical School in Boston surveyed 296 smokers at the end of pregnancy and 3 months' postpartum to determine if heavy smokers and those who had tried, unsuccessfully, to quit during pregnancy were more likely to take anti-smoking medications.

The researchers found that 10% of the women used a smoking cessation medication (nicotine patch, nicotine gum, or buproprion) during their pregnancies and 14.3% used cessation medication within 3 months' postpartum. The relationship between the women's health-care provider discussing specific anti-smoking drugs and the women subsequently selecting the anti-smoking medication was statistically significant.

Rigotti NA, Park ER, Chang Y, et al. Smoking cessation medication use among pregnant and postpartum smokers. Obstet Gynecol. 2008;111:348-355.