The Problem with Smoking During Pregnancy

In the United States it is estimated that 20 percent of pregnant women smoke throughout their pregnancies. It is well-known that smoking is dangerous, especially during pregnancy. Here are a few reasons why:

  • When pregnant women smoke tobacco, carbon monoxide (a lethal gas) and high doses of nicotine prevent the fetus from getting sufficient oxygen. Nicotine is a drug that can easily cross into the placenta, with  concentrations in the fetus that can be as much as 15 percent higher than in the mom. Unborn children and infants of mothers who smoke commonly experience developmental delays and other problems.
  • Women who smoke during pregnancy are at greater risk than nonsmokers for premature delivery. Even babies carried to term are more likely to weigh less at birth, which is associated with a number of health risks. And research shows that the more a woman smokes during pregnancy, the greater the reduction of infant birth weight
  • The adverse effects of smoking occur in every trimester of pregnancy.   In the first trimester, risks include spontaneous abortions while risks in the third trimester include increased premature delivery rates and decreased birth weights

It's never too late to quit smoking. Women who stop smoking cigarettes early in pregnancy significantly cut the risks to their unborn child.
Treating Nicotine Addiction

No one can promise it'll be easy, but there are treatments for nicotine addiction that work. Research has shown that behavioral therapies and medications can help people quit smoking once and for all.  Those who receive treatment for nicotine addiction are 50 percent more successful in quitting smoking than those who receive placebo treatments. In addition to being addiction-free, quitting smoking can have an immediate positive impact on an individual's health. Ffor example, a 35-year-old man who quits smoking will, on the average, increase his life expectancy by five years.

Nicotine Replacement Treatments

Nicotine replacement treatments are one of the most popular ways to quit smoking. Nicotine gum, the transdermal patch, nasal spray and inhalers are examples of common nicotine replacement treatments.  These have proven effective in some people by relieving nicotine withdrawal symptoms while gradually reducing the amount of nicotine in the body. An added benefit is that these forms of nicotine have little potential for nicotine abuse since they do not produce the pleasurable effects of cigarettes and tobacco products. In addition, they  do not contain the carcinogens and gases associated with tobacco smoke.

Nicotine gum was the first FDA approved nicotine replacement treatment. Although nicotine gum provides some smokers with relief from nicotine cravings, others have found  the taste and chewing demands intolerable. For this reason, the FDA approved a number of transdermal nicotine patches, two of which became over-the-counter products.

Nicotine gum and nicotine patches have been estimated to help more than 1 million people overcome nicotine addiction. In the late 1990s, a nicotine nasal spray and  a nicotine inhaler became available by prescription, which have proven equally effective as other treatments for nicotine addiction.

Medications to Treat Nicotine Addiction

Certain medications are being used for relief of nicotine withdrawal symptoms. For example, the first non-nicotine prescription drug, bupropion (an antidepressant) has been used to treat nicotine addiction.

Behavioral Treatments for Nicotine Addiction

Just as effective, if not more so, are behavioral treatments for nicotine addiction. The goals of most counseling sessions and smoking-cessation programs are to help smokers:

  • Identify high-risk relapse situations
  • Create an aversion to smoking
  • Develop self-monitoring of smoking behavior
  • Establish healthier coping skills

    Smoking cessation programs also help smokers learn how to avoid other smokers and tempting smoking environments and lean on support from family and friends. Because addiction is a relapsing illness, one of the most important aspects of nicotine addiction treatment is developing coping skills for both short- and long-term prevention of relapse. In addition to learning tools to prevent relapse,  recovering nicotine addicts must also be ready to apply those skills in a crisis.

The Best Way to Quit Smoking

The most effective way to quit smoking involves a combination of medication and behavioral interventions. One study showed that combining the use of the nicotine patch with a behavioral approach, such as group therapy or social support networks, significantly improved smokers' chances of quitting for good.It won't necessarily be easy -- more than 90 percent of the people who try to quit smoking relapse or return to smoking within one year, with the majority relapsing within one week – but it is possible.

Smoking in Women vs. Men

Men and women differ in their smoking behavior, most likely because of differences in their sensitivity to nicotine. Studies suggest the following gender-based differences:

  • Women tend to smoke fewer cigarettes per day.
  • Women tend to use cigarettes with lower nicotine content.
  • Women do not inhale as deeply as men.
  • Whereas men seem to be attracted to the pleasurable effects of nicotine, women are drawn to other factors, such as the sensory aspects of the smoke or social factors.
  • The prevalence of smoking is slightly higher for men than it is for women, though research shows that more women are beginning to smoke, and women are likely than men to quit smoking.
  • Smoking cessation programs using nicotine replacement treatment, such as the patch or gum, do not seem to reduce cravings to smoke as effectively for women as for men.
Women struggle to quit smoking and are more likely to relapse, possibly because withdrawal symptoms may be more intense for women and they appear more likely than men to gain weight upon quitting.


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