Nicotine patches don’t work

This is a piece of my own research – together with Tim Coleman, who led the whole thing, and many others.  It’s a simple idea.

Nicotine patches, gum, sprays all help non-pregnant smokers quit.  The effect is small but worth it, if it’s you.

But do they work in pregnancy? And are they safe? The answer should be yes to both. Even if nicotine harms babies, it’s probably less damaging than nicotine plus all the other crud in cigarette smoke.

But pregnant women metabolise nicotine quickly, so perhaps the normal dose is too low. And some may not really want to quit.  We know that some actually want their babies to be small in the hope that they’ll give birth more easily! And many past treatments that were believed to be safe in pregnancy turned out to be anything but. Remember diethylstilboestrol, and thalidomide.

So it’s time for a randomised trial. Read the full report in today’s New England Journal of Medicine here.

Nicotine patches don’t work in pregnancy. For a couple of weeks women on the nicotine patches smoked a bit less, but by the end of the pregnancy smoking rates were the same in both groups.  And there were no differences in baby outcomes either.

Oh well.  Time to try something else.  Maybe a higher dose.

Jim Thornton