French Study About Smoking Cessation Management During Pregnancy

The current systematic review conducted by French researchers, analysed international literature published between January 2003 and April 2019, tackling smoking cessation during pregnancy.

Diane Caruana

April 17, 2020

Titled, [CNGOF-SFT Expert Report and Guidelines for smoking management during pregnancy – short text], the review aimed to identify up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy. The researchers looked through Cochrane PubMed and Embase databases, using the relevant keywords.

The compiled data indicated that counselling had a modest positive effect on smoking cessation and the use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRTs) is also recommended for pregnant women who have failed to quit by other means, however the use of e-cigarettes is frowned upon given the lack of scientific evidence on the long term effects of the devices.

Interestingly one of the main factors associated with postpartum abstinence from smoking is breastfeeding, as new mothers would be afraid of passing nicotine to their babies via milk. Other factors are not having a smoker at home, and having no symptoms of postpartum depression.

A possible link between nicotine consumption and SIDS

While no one is suggesting pregnant women should take up vaping for leisure, given that vaping is significantly safer than smoking, heavy smokers who are unable to quit would still benefit by switching to the safer alternatives, as would their offspring.

Meanwhile, a 2019 study from Canada had associated the use of nicotine during pregnancy with sudden infant death syndrome (SIDS). Titled, “In utero exposure to nicotine abolishes the postnatal response of the cardiac sodium current to isoproterenol in newborn rabbit atrium,” this study was published in Heart Rhythm and looked at the effect of nicotine consumption on babies in utero.

The researchers had conducted their study on rabbits, and found evidence linking fetal exposure to nicotine, to long-term changes in the heart function of babies. The researchers explained that these changes may interfere with the adaptation of the babies’ cardiac action potential and could prevent awakening during sleep apnea.

“Clinicians often prescribe NRTs to pregnant women who want to stop smoking to reduce the number of sudden infant deaths,” says researcher Robert Dumaine from the Department of Pharmacology and Physiology at the University of Sherbrooke in Canada. ” However, our data shows that nicotine alone is enough to change the electrical currents in the heart and cause arrhythmias that cause the baby to die,” added the researcher.

E-cigs recommended only for smoking cessation or harm reduction

Meanwhile, in response to studies about e-cig use during pregnancy, vaping advocates have always maintained that such research needs to be put in perspective. It was pointed out that while no one is suggesting pregnant women should take up vaping for leisure and ideally they would abstain from such products completely. However, given that vaping is significantly safer than smoking, heavy smokers who are unable to quit otherwise, would still benefit by switching to the safer alternatives, as would their offspring.