Pregnancy & Baby 

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Nicotine gum or patches

This is a good question for your GP because there is a major controversy about this issue. Some midwives and doctors believe that pregnant smokers should use the gum or patch, and some believe they should not. Packaging inserts will generally say they should not be used in pregnancy and this has been the consensus until recently.

An article by Oncken et al. in the journal Clinical Pharmacology & Therapeutics (June 1996) compared blood concentrations of nicotine and cotinine (a nicotine by-product) and maternal and foetal haemodynamic effects in nicotine gum users and cigarette smokers. The dosage was six pieces of two-milligram nicotine gum per day. Blood nicotine and cotinine concentrations, maternal heart rate and blood pressure, foetal heart rate and umbilical artery resistance were obtained before the study and after five days. A significant reduction from baseline in nicotine and cotinine concentrations was observed in those who chewed nicotine gum compared with those who continued to smoke.

I would be concerned about a pregnant patient using this drug and continuing to smoke, thus doubling her and her baby's exposure.

Good luck. I'm sure that you can quit, and now is the time.

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