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Stopping smoking is the single most effective intervention for improving the health of both the pregnant smoker and her babyand the earlier abstinence is achieved the betterHoweverif the mother cannotor is considered unlikely toquit without pharmacological supportNRT may be used as the risk to the fetus is lower than that expected with smoking tobaccoStopping completely is by far the best option but Nicotinell patches may be used in pregnancy as a safer alternative to smokingBecause of the potential for nicotine-free periodsintermittent dose forms are preferablebut patches may be necessary if there is significant nausea and/or vomitingIf patches are used they shouldif possiblebe removed at night when the fetus would not normally be exposed to nicotine.
Nicotine is a toxic substanceDoses of nicotine that are tolerated by adult and adolescent smokers can produce severe toxicity in small children that may be fatalsee section 4.9Both before and after usethe patch contains a significant amount of nicotineSubjects must be cautioned that the patches must not be handled casually or left where they might be inadvertently misused or consumed by childrenUsed patches must be disposed of with care by folding them in half with the adhesive sides inwardsand ensuring that they do not fall into the hands of children under any circumstances.
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