It is common knowledge that smoking during pregnancy is harmful, and many women struggle to give up the habit due to the addictive chemicals in cigarettes. But a group of researchers from the University of Newcastle say there is not enough discussion around the recommendation of nicotine replacement therapy for pregnant women. In a new paper published by the researchers, they argue nicotine replacement therapy is safer than smoking, and Australian doctors can be confident prescribing it for their pregnant patients. In 2004, 11 per cent of women who gave birth in Australia smoked at some point in their pregnancy. That number is higher for Aboriginal and Torres Strait Islander Women, at 45 per cent. Smoking during pregnancy reduces the growth and health of babies, and increases the chance of complications for mother and child. Children born to a mother who smokes have a greater chance of premature birth, low birth rate, stillbirth and infant mortality. Cigarettes are addictive due to the nicotine, which is a found naturally in tobacco. But University of Newcastle School of Medicine and Public Health associate professor Gillian Gould said nicotine could also be the solution to help smokers quit throughout their pregnancy.
Nicotine replacement a recommended therapy
Dr Gould is a co-author of the paper in the Medical Journal of Australia encouraging doctors to recommend nicotine replacement therapy to patients who are unable to quit unassisted when pregnant. Current Australian and New Zealand guidelines recommend the use of nicotine replacement therapy by pregnant women who are unable to quit without medication. But the paper states in a recent survey of Australian GPs and obstetricians, 25 per cent of participants never prescribed nicotine replacement therapies during pregnancy. Dr Gould said clinicians were concerned about recommending the products due to safety concerns. “That was one of the evidence-based gaps we found. Health providers and doctors were not confident, and [were] needing more help to know how to use nicotine replacement therapy.”
One chemical vs 7,000
Dr Gould said clinicians needed to have the discussion with their patients who were pregnant and unable to quit cold turkey. “When you smoke cigarettes, you’re getting 7,000 different toxic chemicals and you’re breathing in carbon monoxide, which attaches to the blood cells and then the baby doesn’t get the right amount of oxygen through the placenta,” she said. “Nicotine is only one chemical among those 7,000.” She said ideally it would be best not to have any sort of nicotine, but the risks should be weighed up. “We believe the nicotine you have in nicotine replacement therapy is much lower in dosage. “It’s more regulated and it’s not absorbed as much as the nicotine in cigarettes. So it’s far less dangerous to take nicotine replacement therapy than to smoke. “We need to be able to explain that to women and have that discussion about the risks and benefits.”
ABC News, 4 December 2017 ; http://www.abc.net.au/news/