Quitting smoking: What works in pregnancy?

Quit smoking support programmes can help pregnant women quit smoking. Nicotine replacement therapy might not be more effective than other programmes.

Smoking in pregnancy increases the risk of a woman having a miscarriage, and chances of the baby being born too early or too small are higher too. These babies are at risk of serious lung complications.

Women are more likely to quit smoking while they are pregnant that at other times. About 4 out of 10 pregnant women (40%) have already quit smoking by the time of their first antenatal or prenatal visit, but most need help. So a variety of support programmes are offered to help pregnant women quit. These programmes can include education, counselling or group sessions.

To weigh up the advantages and disadvantages of different options, researchers from the Cochrane Collaboration looked for trials and systematically analysed them. Trials including more than 20,000 pregnant women show that a variety of programmes can help pregnant women quit smoking. The trials showed that out of women who did not get help from a support programme or use nicotine replacement therapy (NRT), around 90 out of a 100 (90%) start smoking again before the end of pregnancy. But out of 100 women who participate in some kind of quitting programme or therapy, about 85 go back to smoking. Put another way: with support from a programme or therapy, the extra success rate for quitting was around 5 out of 100 women (5%).

Importantly, the Cochrane researchers also found that the babies of mothers who had gotten help to quit smoking were less likely to be born too early or under-developed.

NRT was not more successful than quitting programmes without medication. It is still not known whether or not NRT can cause health problems for unborn babies.

© IQWiG (Institute for Quality and Efficiency in Health Care)