Get help to stop smoking
If you stop smoking now it will make a big difference to your health and the health of your developing baby. The earlier you give up smoking in pregnancy, the better. But quitting at any stage will benefit both you and your baby, so don't give up on giving up.
If you're finding it difficult to quit smoking, it's really important to get help. People who get help from stop smoking advisers (see below) are four times more likely to quit successfully. Your doctor or midwife can guide you towards any help and advice that's available.
You can also look for an app. Some give you daily tips, advice and encouragement, such as showing you how much you are saving and showing how you are benefiting from being smoke-free. The NHS has a quit app that has all of the above. You can put a scan picture of your baby in as motivation.
Stop smoking advisers in pregnancy
The most effective way to quit smoking for many people is to get help from your local NHS Stop Smoking Services. People who give up with support and advice from a Stop Smoking adviser are four times more likely to succeed than those relying on willpower alone! Trained advisers will offer you one-to-one help.
Depending on where you live, there may be a Stop Smoking adviser who is able to come to your home or talk to you on the phone. As well as your local Stop Smoking clinic, you may also be able to get this kind of specialist advice from your local pharmacy.
Your Stop Smoking Service may offer one-to-one or group sessions. You can bring a friend or partner if you find it helpful.
At your first meeting the adviser will ask questions to get to know you. They will want to know how long you have been smoking, how much you smoke and when you have your first cigarette of the day. They will also ask about whether people in your household smoke.
Together you can work out a plan for how to stop smoking and cope with the withdrawal symptoms. The adviser will help you deal with your physical addiction to nicotine and will show you how to manage cravings and stress without reaching for a cigarette.
Even if you have failed to quit many times in the past, the advisers will be keen to help. They are used to working with people who are finding it a struggle. They have a range of ways to give expert advice, information and support to help you stop smoking for good.
Nicotine replacement therapy (NRT) in pregnancy
Nicotine is very addictive and it is common to have strong cravings for cigarettes and withdrawal symptoms such as restlessness and irritability.
If you are really struggling to quit, you might consider nicotine replacement therapy (NRT). Licensed NRT products are free of charge, safe to use in pregnancy and can increase the chances of quitting successfully. The product eases the withdrawal symptoms by giving you small amounts of nicotine but without the harmful toxins and chemicals you get from smoking tobacco.
NRT is available in different doses, which are prescribed according to how much you were smoking before you stopped. You can then slowly reduce the amount of NRT you are using until you don’t need it at all.
Licensed NRT products can increase the chances of quitting successfully. This is particularly the case when combined with specialist help from local stop smoking services.
NRT products include:
Patches are small stick-on squares that look like plasters you put on for a cut. The release the nicotine into your bloodstream through the skin. They can be worn around the clock or only during the day. They come in different strengths and you can gradually reduce this.
Nicotine chewing gum
You can get this in two doses 2mg and 4mg. As an indication the 4mg would be for you if you smoked more than 20 cigarettes a day. You keep the gum in your mouth until the taste has worn off and chew on it when you feel like you need some nicotine. When you first quit you would be using around one piece of gun an hour.
Tablets, strips or lozenges
These are taken in your mouth and can be rested in your cheek. They dissolve slowly to release the nicotine. To release the nicotine you suck the lozenge. If you get mouth ulcers you should not use lozenges.
The inhalator is similar in shape to a cigarette so if you feel you might miss the physical action of smoking this might be a good choice for you. They work quickly so you use them when you have a strong craving for a cigarette. The inhalator has a disposable cartridge that has enough nicotine for three to four puffing sessions. You gradually reduce the amount of cartridges that you use.
Spray for your nose
The spray gives you a quick dose of nicotine through your nose. You spray into each nostril twice an hour. It is the fastest way that nicotine can reach the brain. It is the strongest form of nicotine replacement and can work well if you were a heavy smoker.
The prescription tablets Zyban and Champix are not recommended in pregnancy.
No one type of NRT has been shown to work better than another so you can choose which one suits you.
You can also combine NRT products, you could wear patches through the day, for example, then use gum or an inhalator to get rid of a sudden craving for a cigarette.
E-cigarettes also contain nicotine and are used by some to help quit smoking. Although they are safer than smoking cigarettes, they have not been tested for pregnancy as licensed NRT products have and the risks to the baby of the vapour is not known. Therefore, licensed NRT products, which are available free of charge on the NHS, are a better first option.
Can I take medicine to help me quit smoking?
Medication that doesn't contain nicotine, such as varenicline and bupropion, is often used to help people stop smoking but these are not recommended for use in pregnancy.
Helplines, websites and smartphone apps for quitting support and advice:
There is plenty of friendly, professional support available online and by phone to help you stop smoking.
This website offers advice, information and support, along with a free Quit Kit and other resources. There are also success stories to boost your resolve and help you keep on track. As well as visiting the website you can call the free Smokefree helpline on 0300 123 1044.
QUIT is a charity that also has professional advisers, along with tips, tools and ideas to help you quit smoking. You can also call their free helpline on 0800 00 22 00.
Action on Smoking and Health (ASH)
ASH is a charity that works to raise awareness about tobacco use and campaigns for ways to eliminate the damage caused by smoking. You can find information about different aspects of smoking and quitting, along with links to more stop smoking websites.
SmokeFree Baby is a smartphone app to help you give up smoking completely or substantially reduce the number of cigarettes you smoke during pregnancy. It has been developed by a team of experts at University College London, and it is available for free on iOS and Android.
- Smoking in Pregnancy: Communication with Women Working Group (2015) Shared key messages
- West, R. (2006) Feasibility of a national longitudinal study (‘The Smoking Toolkit Study’) to monitor smoking cessation and attempts at harm reduction in the UK.
- NICE (2010) Quitting smoking in pregnancy and following childbirth Issued: June 2010 NICE public health guidance 26
- NHS Go smokefree [accessed 21/11/2014] Support services http://www.nhs.uk/smokefree/help-and-advice/local-support-services-helplines
- Cooper et al 2014, Effect of nicotine patches in pregnancy on infant and maternal outcomes at 2 years: follow-up from the randomised, double-blind, placebo-controlled SNAP trial, The Lancet Respiratory Medicine http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(14)70157-2/fulltext?_eventId=login
- Coleman at al 2012, A Randomized Trial of Nicotine-Replacement Therapy Patches in Pregnancy N Engl J Med 2012;366:808-18 http://www.nejm.org/doi/full/10.1056/NEJMoa1109582
- NHS Choices [accessed 28/04/2015] Prescription medicineshttp://www.nhs.uk/smokefree/help-and-advice/prescription-medicines
- NHS Choices [accessed 21/11/2014] Stop smoking treatments http://www.nhs.uk/conditions/smoking-%28quitting%29/Pages/Treatment.aspx