Smoking cessation and pregnancy

Active and passive smoking during pregnancy induce several deleterious effects that may have a negative impact on pregnancy progress, fetus development and both mother and newborn health. Smoking cessation should be a rule for any woman as soon as the beginning of her pregnancy, or better in anticipation of a pregnancy when contraception is no more taken. Every caregiver must help every pregnant woman who smokes to quit smoking. Smoking cessation interventions in pregnant women must combine a psychological support (mainly with cognitive behavioral therapy) and nicotine replacement therapy, which can also be used during breast feeding. It is recommended to adjust the dosage of nicotine replacement therapy according to the symptoms of under or over dosage at the end of the first week of use. On the other hand, vareniclin and bupropion are contra-indicated during pregnancy or breast-feeding. Electronic cigarette is not advised during pregnancy. Prevention of smoking relapse in postpartum period is essential since a percentage as high as 50% of women having quit during their pregnancy resume smoking during the 6 months following delivery. (C) 2017 Published by Elsevier Masson SAS.