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Smoking cessation - Management
Smoking cessation - pregnant or breastfeeding women
How do I manage a pregnant or breastfeeding woman who wants to stop smoking?
The preferred management is referral to an intensive support service, such as the NHS Stop Smoking Services.
- For women who do not want referral:
- Offer practical advice and follow up to help them stop smoking.
- Advise stopping without using any drug treatment for women who feel confident they can manage without.
- For women able to stop smoking but who are likely to relapse without treatment, offer nicotine replacement therapy.
In depth
What practical advice can I give to a woman who is pregnant or breastfeeding to help her stop smoking?
Advise women who want to stop smoking to:
- Prepare mentally to stop by:
- Making a list of reasons why they want to stop.
- Explaining that most of the pleasure of smoking comes from the relief of nicotine withdrawal symptoms.
- Expecting stopping to be difficult but progressively easier after the third or fourth day.
- Involving family and friends by telling people about their intention to stop and, if possible, stopping with someone else.
- Set a date to stop smoking when they feel well and under the least amount of stress possible. Advise people to stop immediately if they are motivated to do so.
- Avoid relapses by:
- Using nicotine replacement therapy to relieve the symptoms of nicotine withdrawal.
- Avoiding situations associated with smoking until they can comfortably resist the impulse to smoke.
- Replacing smoking with other activities, such as chewing gum, drinking water or tea, or taking glucose tablets relieve nicotine cravings.
- Setting targets for remaining smoke free and rewarding themselves for reaching these targets.
- Try again if they relapse. Most people who successfully stop smoking long term need several attempts before they finally stop completely.
In depth
What drug treatment should I prescribe for a woman who is pregnant or breastfeeding to help her stop smoking?
- Nicotine replacement therapy is recommended for pregnant and breastfeeding women who are unable or unlikely to stop smoking without drug treatment.
- Bupropion and varenicline are not recommended for use in women who are pregnant or breastfeeding.
In depth
How do I follow up someone who is pregnant or breastfeeding who has started treatment to stop smoking?
- For women stopping smoking without nicotine replacement therapy (NRT), review within 7 days of the stop date and offer NRT to those who have not stopped smoking or who are having difficulty not smoking.
- For women stopping smoking completely with NRT, review within 2 weeks of their stop date:
- For those who continue to smoke, reassess their readiness to quit by asking them whether they would like help to continue with their quit attempt. Continue treatment if they demonstrate a continuing attempt to stop. Treat for up to 12 weeks after stopping smoking.
- For those with adverse effects from treatment, consider reducing their dose, or changing the formulation.
- For those with significant nicotine withdrawal symptoms on treatment, consider increasing the dose of NRT (up to the maximum licensed dose that is tolerated).
- For women remaining smoke free and managing well review each month and prescribe further NRT for up to 12 weeks.
In depth
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