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Expert Q&A

 

By Myron Bethel
Obstetrician and Gynecologist

I've heard a lot about why I should quit smoking, but I can't find any information about how I should quit while pregnant. Should I quit "cold turkey?" Will medication be harmful to my baby? What about the patch or the nicotine gum? What's best for my baby?

You have asked a difficult question to accurately answer, but I will try. First, you are correct: smoking is harmful in pregnancy, as has been well documented. The nicotine, tars, and carbon monoxide have been associated with spontaneous miscarriage, congenital defects, and low birth weight babies. So, it is obvious that everyone, especially pregnant women should not smoke. But how does one stop, during pregnancy, something that is so physically and psychologically addictive?

The recommended course of action includes behavior modification techniques. This means taking a day-by-day proactive stance to not smoke. This can be done by keeping diaries, smoking avoidance behavior, writing down positive results of being smoke-free (both to you and the baby rewarding yourself with things such as personal gifts, trips, etc.

Of course, if this worked, universally, everyone would be a non-smoker. The fact that it doesn't work for some is why nicotine gum/patches are so successful. But you can not use them while pregnant, for the very reason that you can't smoke. Decreased uterine blood flow, which results in small babies, defects, and maternal increased blood pressure, are just some of the few reasons why. Nicotine's effects are difficult to separate from smoking, but nicotine at patch levels can still have an adverse effect.

"Cold Turkey" as well, can be physically and emotionally difficult, but if coupled with behavioral techniques, this would be your best bet. Good luck.

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