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Nicotine replacement therapy or bupropion may be helpful for pregnant smokers who have been unsuccessful in quitting with behavioural support alone.

A review of six trials enrolling 1745 participants concluded that there was insufficient evidence to determine whether or not NRT was effective or safe when used to promote smoking cessation in pregnancy. Nevertheless, since smoking cessation during pregnancy is so important and since NRT use is safer than cigarettes, use of NRT for cessation in pregnancy can be justified. Most recommend use of NRT only in those who have failed a behavioral treatment and use of lower doses of NRT. The risks of NRT in pregnancy are outlined in the safety section. There is limited information about the safety of bupropion in pregnancy

Coleman T, Chamberlain C, Davey MA, Cooper SE, Leonardi-Bee J. Pharmacological interventions for promoting smoking cessation during pregnancy. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD010078. DOI: 10.1002/14651858.CD010078.

Coleman T, Britton J, Thornton J. Nicotine replacement therapy in pregnancy. Br Med J. 2004; 328: 965-966.

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