Are nicotine patches safe for pregnant women?

Aug 26 2004

A £1 million study, being led by a team of multidisciplinary researchers at The University of Nottingham, is to look at whether nicotine replacement skin patches could help pregnant mums to stop smoking.

The Smoking, Nicotine and Pregnancy (SNAP) trial, being led by Dr Tim Coleman in the Division of Primary Care, will also aim to provide evidence for health professionals that the use of these skin patches by pregnant women is safe for their unborn child.

Despite Government education campaigns warning of the dangers associated with smoking during pregnancy, around 30 per cent of pregnant women still light up while pregnant. Of those, only one in four are able to stop for even part of the pregnancy and a large proportion continue to smoke for the entire nine-months. Of those women who do give up smoking during pregnancy, around two-thirds take up the habit again once their baby is born.

Smoking is believed to cause 4,000 miscarriages and stillbirths every year and is strongly linked with low birth weight, premature births and an increased risk of neonatal mortality and Sudden Infant Death Syndrome. Children whose mothers smoked while pregnant are also more likely to develop asthma, attention deficit hyperactivity disorder (ADHD), learning problems and are also more likely to smoke themselves in later life.

Tackling smoking among pregnant women is one of the Government’s key targets, as set out in its white paper Smoking Kills. It recently released figures that showed that advice from a GP followed by the use of nicotine replacement therapy (NRT) can double the chances of patients giving up smoking.

However, no such figures currently exist for pregnant women using NRT and the Nottingham trial is hoping to conclusively prove that NRT can be used successfully and safely by pregnant women wanting to kick the habit. Pregnant women also get rid of nicotine more quickly from their body, so the study will look at whether the current doses offered by nicotine patches are sufficient for their needs.

Funded with £1.1 million from the Medical Research Council, the trial will recruit more than 1,000 pregnant women who are interested in giving up smoking when they attend ante-natal ultrasound appointments at five different hospitals in the East Midlands. The six-year randomised study will offer some of the women a nicotine patch and others a placebo and both sets will be offered support from their local NHS stop smoking services. The smoking cessation rates will be monitored and the babies born from the trial will be studied for two years to assess the safety of using NRT in pregnancy compared with smoking.

The team includes other colleagues from the University’s Schools of Community Health Sciences, Medical and Surgical Sciences and Human Development under the umbrella of the Institute for Clinical Research, as well as researchers from the universities of Dundee and York.

http://www.nottingham.ac.uk/