GPs should use behavioural support in pregnant women wanting to give up smoking as nicotine replacement therapy has little effect on quit rates, a UK trial has found.
The researchers said guidelines should be revised after their study showed no difference in abstinence rates between pregnant smokers given NRT and placebo.
The study looked at 521 women aged 16 to 50 years, between 12 to 24 weeks of pregnancy and who smoked five or more cigarettes a day. The women were all given behavioural cessation and agreed a quit date, and then were randomised to either a nicotine patch or placebo.
Women who reported not smoking to researchers were visited to obtain validation by measuring their exhaled carbon monoxide concentration.
They found the rate of women not smoking was significant at one month, but at delivery with validation was non-significant between the two groups, with rates of 9.4% in the NRT group compared to 7.6% in the placebo group.
The researchers said their study backed up previous smaller studies, and should prompt a change in the guidance given to GPs.
Study lead Dr Tim Coleman, of the University of Nottingham, said: ‘The present findings suggest that guidelines for smoking cessation in pregnancy should be revised to encourage the use of only those interventions that have a secure evidence base – specifically behavioural support.'
New England Journal of Medicine 2012, published 1 March