Australian Birth Defects Society

A Society devoted to the study of birth defects


Smoking has been recognised as a major preventable cause of adverse outcomes in pregnancy, and stopping at any time in the pregnancy will reduce the risks for baby. Many pregnant women are much more motivated to quit, and do so successfully in early pregnancy. For those who find it harder to stop smoking without help, counselling and hypnotherapy can be utilised.

What about nicotine replacement therapy (NRT)?

Nicotine replacement therapy can be considered for women who require extra support. Although research is still limited, it is generally felt that nicotine replacement therapy is less harmful than continuing to smoke cigarettes. This is because although NRT is a source of nicotine, it does not contain any of the other harmful chemicals, or carbon monoxide gas inhaled in cigarette smoke. By eliminating the high levels of carbon monoxide from cigarette smoke, baby receives more oxygen from the moment the pregnant woman replaces cigarettes with NRT product. NRT should always be used with medical advice and support. Women should use the lowest effective dose, and only use as instructed. Intermittent products such as gum, inhalers, spray and lozenges are preferred in pregnancy. If a nicotine patch is used, it should be removed at night before bed. It is important that women understand that they must not smoke while using NRT, as this can result in a very high nicotine exposure.

Are e-cigarettes the same as NRT?

E-cigarettes have become popular over the last few years, and in some countries are promoted as another harm minimisation option for smokers. The ingredients used in the e-liquids can vary considerably and manufacturing is unregulated (without appropriate regulation, it is impossible to be confident about whether the product ingredients and quantities are accurate as labelled). Currently e-liquids containing nicotine are not available for purchase in Australia, although products bought online may be shipped here. Because of the lack of long term data, and concerns about unregulated ingredients in e-liquids, e-cigarettes are not recommended at any stage of pregnancy.

Can other smoking cessation products be used in pregnancy?

Bupropion and varenicline are prescription medicines which are used to aid smoking cessation, but currently there is little research to confirm the effectiveness of either drug during pregnancy. Available information does not indicate increased risk when bupropion is used in pregnancy, but there is inadequate safety data to support the use of varenicline. Consult your doctor if NRT is not effective and you are considering the use of either of these medicines to aid smoking cessation in pregnancy.





For specific information regarding your particular medications in pregnancy or breastfeeding call MotherSafe 02 9382 6539 or 1800 647 848 (from country NSW only).

Page updated 11 December 2017

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MotherSafe is a free telephone service for the women of NSW, based at the Royal Hospital for Women, Randwick.

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