Impact on Smoking Cessation during Pregnancy using Therapeutic Interventions like Nicotine Replacement Therapy (NRT) and Electronic Nicotine Delivery System (ENDS) in the U.S.A

A particularly important risk factor during pregnancy is smoking which is associated with harmful consequences related to pregnancy. Levels of smoking during pregnancy differ between geographical regions, with estimates of 7.2% in the US and 10.8% in the UK.  Direct and passive tobacco use is related to many detrimental illnesses including epigenetic changes from intrauterine nicotine exposure, which have intergenerational negative perinatal consequences, and mortality. A substantial fraction of pregnant women continues to smoke during this vital phase, even though knowing the fact that outcomes will be drastic. In these paper mediations, aiming for smoking cessation in pregnant women would be assessed. Counseling appears to improve infant morbidity and mortality rates along with pharmacological therapy.

Pharmacotherapy is urged for women who are heavy smokers and are unable to quit this habit. Pharmacotherapy includes many strategies like Nicotine replacement therapy with nicotine patches, gums, and nasal sprays. Another way of smoking cessation seen in the USA more often is electronic cigarettes. All these strategies are affecting the reproductive health of mother and fetus either positively or negatively during pregnancy but the reports and studies on this topic are lacking and very limited data is available. In this paper, we will also aim to review the latest knowledge from human and animal studies regarding the direct and indirect effects of maternal nicotine exposure on pregnancy in both long terms and short terms duration.

Conclusion:  Nicotine Replacement Therapy (NRT) used by pregnant women for smoking cessation increases smoking cessation rates by overall approximately 40% measured in later pregnancy. However, there is a shred of evidence that Nicotine Replacement Therapy is no more competent than the placebo (dummy drug). It was also seen that Nicotine Replacement Therapy (NRT) used in later pregnancy for smoking cessation has any effect, either positive or negative impact on childbirth offshoot. We have evidence of only one trial for follow up indicating Nicotine Replacement Therapy used by the pregnant women suggested positive healthy developmental outcomes in the baby. 

Author(s): Muhammad Idrees

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