Pregnancy and Smoking

Pregnancy and SmokingPregnancy gives you a huge incentive to quit smoking, but it also complicates your choice of methods. You may not be able to quit on your own, but you also have to think twice before exposing your baby to the medications in pills and patches. So what are the best options?

Successful quitters have found different ways to kick the habit. Some try the drug bupropion (Zyban) or nicotine patches, gums, or
sprays — which are generally safe when used under the guidance of a doctor. (They’re certainly safer than cigarettes.)
Others try counseling, perhaps in combination with a medication. Others just go the old-fashioned route and throw
away their cigarettes. No approach is right for everyone, and you may have to try a few different strategies or combinations before you find the one that works for you. Here’s a look at your options.

Quitting cold turkey

How it works: You throw out your cigarettes and vow not to smoke again.

Safety: You may feel lousy for a few weeks, but you won’t be doing yourself or your baby any harm. There’s no evidence that the stress of quitting has any effect on a fetus.

Success rate: In the general population, only about one in 20 people who go cold turkey without any other quitting aid manage to stay away from cigarettes. But during pregnancy you’re more likely to beat those odds because you’re more motivated to quit. And you can boost your chances of success by trying nicotine replacement or one of the other quitting aids listed below.

Pros: Quitting cold turkey is inexpensive and safe. If you do it on your own, you won’t have to make a doctor’s appointment or get a prescription. Most important, you’ll immediately stop exposing your baby to carbon monoxide, nicotine, and other dangerous chemicals in cigarettes.

Cons: If you’re a heavy smoker, you can expect to suffer from nicotine withdrawal for two to three weeks after quitting cold turkey. Symptoms include irritability, depression, anxiety, difficulty concentrating, and restlessness. For the first couple of weeks, you’ll also have powerful cravings for cigarettes.

Quitting gradually

How it works: You gradually cut back on cigarettes until you’re down to zero.

Safety: This method is completely safe — if you do it quickly enough. As long as you’re cigarette-free by the time you’re 14 weeks
pregnant, doctors say, your baby isn’t likely to be harmed. But if you’re still smoking after that point — even if it’s just one or two cigarettes
a day — you could be stunting your baby’s growth and opening the door to complications.

Success rate: Overall, cutting back gradually is no more effective than quitting cold turkey — it works for roughly one in 20 smokers.*
However, the small-steps approach may be a better choice if you smoke a pack a day or more.

Pros: Quitting gradually may help minimize the symptoms of nicotine withdrawal, especially if you’re a heavy smoker. Your body will have
a chance to slowly adjust to the diminishing supply of nicotine in your bloodstream.

Cons: Those last couple of cigarettes may be especially hard to give up. And until you quit completely, you’re still endangering your baby and yourself.

Nicotine replacement

How it works: Nicotine is the addictive chemical in cigarettes. Nicotine patches, gums, and sprays help prevent nicotine withdrawal when
you quit.

Safety: Nobody knows exactly how nicotine affects a growing fetus or how much it contributes to low birth weight, premature birth, and
other complications. But since nicotine is just one of many toxins in cigarette smoke, this method is almost certainly safer for you and
your baby than smoking. Still, you should talk to your doctor before trying any type of nicotine replacement. Gums and sprays are
considered safer than patches because the short bursts of nicotine they provide add up to smaller doses of nicotine than you’d get from
a patch (or from smoking, for that matter). A patch may still be a good choice if you’re too nauseated to try anything else, but you should
only use brands that release nicotine for 16 hours instead of 24. The 16-hour patches are just as effective as the all-day patches, but
they’ll put less nicotine in your system.

Success rate: Nicotine replacement can boost smokers’ chances of quitting successfully, from roughly one in 20 to one in ten.*

Pros: Nicotine replacement treatments can help take the edge off your cigarette cravings. These treatments can be especially helpful if
you’re a heavy smoker or have had trouble quitting cold turkey.

Cons: There’s a small chance that nicotine replacement treatments could be harmful to your baby, especially if you wear a 24-hour
patch or overuse gum or sprays. Talk to your doctor before giving them a try.

Cost: About $120 to $140 for a one-month supply of gum, $70 to $100 for a one-month supply of patches, and $160 for a one-month
supply of nasal spray. (Note: Many insurance companies will cover part or most of the cost of smoking cessation treatments.)

Bupropion (Zyban)

How it works: This medication was originally marketed as an antidepressant under the brand name Wellbutrin. Doctors noticed that
patients taking the drug were unusually successful in their attempts to quit smoking. Researchers aren’t sure why it helps smokers quit.

Safety: Bupropion is generally considered safe, but it has never been thoroughly studied in pregnant women. Large doses of the drug
have been known to cause seizures. (There are no reports of this ever happening to a pregnant woman taking the medicine to quit
smoking.) The drug may not be safe for women who are already at a high risk of seizures, including those with preeclampsia or a history
of preeclampsia. Bupropion passes through breast milk, so it isn’t recommended for nursing mothers.

Success rate: Bupropion can boost smokers’ chances of quitting successfully from roughly one in 20 to one in ten.*

Pros: Bupropion is nicotine-free and easy to take. As a bonus, smokers who quit with the help of bupropion tend to gain less weight than
other quitters.

Cons: Known side effects include insomnia, dry mouth, and nausea. It’s unknown what effect, if any, this medication could have on
your developing baby.

Counseling

How it works: Whether you get a few words of encouragement from your doctor, call a quit line, join a group program, or have a
one-on-one session with an expert in smoking cessation, counseling can help keep you focused and motivated to quit.

Safety: It’s safe.

Success rate: It pays to have an expert on your side. Smoking cessation counseling can boost smokers’ chances of quitting successfully
from roughly one in 20 to one in ten.* Women who need extra help can combine counseling with other treatments such as bupropion
(Zyban) or nicotine replacement.

Pros: Counseling directly addresses the thoughts and behaviors that make the difference between success and failure. Besides, talking
to someone can help lower your stress, a good thing regardless of your smoking habit.

Cons: Few to none. If a certain forum or counselor doesn’t work for you, you can always try a different one.