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Smoking Cessation in Pregnancy: Why, How, and What Next

CRAWFORD, JULIE T. MD*; TOLOSA, JORGE E. MD, MSCE* †; GOLDENBERG, ROBERT L. MD† ‡

Clinical Obstetrics & Gynecology: June 2008 - Volume 51 - Issue 2 - pp 419-435
doi: 10.1097/GRF.0b013e31816fe9e9
Societal Factors in Pregnancy: Why Worry?

Smoking cessation in pregnancy has been shown to reduce low birth weight, preterm birth, and infant morbidities. The effectiveness and safety profile of current cessation approaches in pregnancy are presented. The highest cessation rates are associated with counseling and behavioral interventions. Further studies are needed to evaluate the safety and efficacy of pharmacotherapy in pregnancy including nicotine replacement therapy, bupropion and the recently approved drug Varenicline. The risks and benefits of nicotine replacement therapy in heavy smokers and bupropion are discussed. Data on fetal risk are not yet available for Varenicline.

*Department of Obstetrics and Gynecology, Oregon Health and Science University

Global Network for Perinatal and Reproductive Health, Portland, Oregon

Department of Obstetrics and Gynecology, Drexel College of Medicine, Philadelphia, Pennsylvania

Correspondence: Jorge E. Tolosa, MD, MSCE, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Mail Code L-458, Portland, OR. E-mail: tolosaj@ohsu.edu

© 2008 Lippincott Williams & Wilkins, Inc.