These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Nicotine replacement
Question: I’m looking for recent information about use of nicotine replacement during pregnancy.
Answer: That study has been done with cigarettes as the source of the nicotine. The nicotine patch or nicotine gum may have slightly less effects, but probably similar. The addition of nicotine will decrease the placental size and oxygen carrying capacity of the blood. Consequently, the babies of smokers are about 1/2 to 1 pound lighter and tend to have earlier onset of labor by two weeks or so on average. The birth scores of nicotine babies are slightly less than non-nicotine babies. One does not apparently see the developmental problems that alcohol causes, but further research is in progress.
Smoking Cessation
Question: Now that Nicoderm patches have gone OTC, how do you know
when to suggest to a patient to consider nicotine replacement
therapy?
Answer: Whether to use a drug has little with its availability. The cessation rate for stopping smoking is about 10-15%. This rises about 5% or so with the use of nicotine patches. This is particularly true of those patients who are truly nicotine addicted versus socially addicted. That is, some patients smoke at predictable times dictated by social parameters.(Breaks, parties, first cup of coffee, etc.). Others are “climbing the walls” with any cessation of nicotine intake. This is the best group to use patches, although both groups will benefit.
