NRT safety in pregnancy
Nicotine is not the harmful part of cigarettes – it’s the smoke that damages you and your baby. Nicotine in the form of NRT is safe to use in pregnancy and is recommended by the NHS.
It’s not the nicotine in cigarettes that harms your baby’s health, it’s the smoke
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Nicotine is addictive when smoked - this makes you crave cigarettes. But nicotine isn't the part of cigarettes that causes damage to you or your baby. Tobacco smoke contains thousands of harmful toxins, including carbon monoxide and many cancer-causing chemicals.
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Every time you smoke, carbon monoxide enters your bloodstream from your lungs, and passes through the placenta into your baby’s bloodstream. This cuts down your baby's oxygen supply and effectively suffocates him or her a little. Even smoking very few cigarettes can harm you and your baby – this includes second-hand smoke from people around you.
Nicotine alone is virtually harmless
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Nicotine Replacement Therapy (NRT) provides clean, safe nicotine, so you won’t be getting the toxins in cigarettes that harm you and your baby. Nicotine itself is relatively harmless. Much like the caffeine in coffee, it can be addictive but causes very little - if any - harm to health. The nicotine in NRT has never been shown to cause harm to pregnant women or to their babies. And nicotine alone does not cause cancer – this is one reason why NRT is at least 99% safer than smoking.
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NRT can help you to stop smoking completely - this is best for you and your baby. As soon as you start to use NRT instead of smoking, your baby will get more oxygen and will grow more healthily.
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Quitting smoking as early as possible in pregnancy is best but quitting at any stage is beneficial. Using NRT to cut out all smoking is a lot better for you and your baby than just cutting down - there’s no ‘safe’ amount of smoking in pregnancy.
The NHS says NRT is safe to use in pregnancy
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The NHS has provided NRT free of charge to pregnant women for over 15 years. This is because stopping smoking is so important for the health of you and your baby. Helping pregnant women to quit saves lives and saves NHS healthcare costs for mothers and babies.
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NRT is the only stop smoking medication that the NHS considers safe and recommends in pregnancy - it’s fine for you to use any type of NRT. Nowadays, the NHS offers pregnant quitters two types of NRT (combination NRT) because this works better than using only one type – of course, they wouldn’t offer this if it wasn’t safe. You might have heard of other stop smoking medications like Champix or Zyban but these are not allowed in pregnancy.
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You might come across some people - and this can even include doctors and nurses - who are unsure about using NRT in pregnancy. However, experts and up-to-date medical advice are very clear that NRT is safe to use in pregnancy.
Medical research shows that NRT is a safe way to quit smoking during pregnancy
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High-quality research studies involving many thousands of women and babies do not show any harms from using NRT in pregnancy. On the other hand, smoking in pregnancy is the leading cause of complications in pregnancy and childbirth in the UK. Using NRT in pregnancy is considered safe whereas continuing to smoke in pregnancy is known to be very harmful to both of you.
Common myths about smoking in pregnancy
Isn’t the stress from quitting worse for my baby than continuing to smoke a bit?
Some women worry that the stress of going without cigarettes is bad for the baby but it’s not – this is just a myth. Using NRT will make going without cigarettes less stressful for you, and stopping smoking means a healthier baby. You'll feel less stressed a few weeks after quitting.
What's the problem with a smaller baby? Won't a smaller baby be easier to deliver?
Smoking does cause babies to be born smaller - but they are only smaller because smoking stunts their growth in the womb. They are more often born premature and more likely to need to go into special care units. Babies who are smaller due to stunted growth are less healthy - they have a poor start in life and are more likely to have serious health problems as both children and adults, like asthma and bronchitis. A smaller baby won’t make delivery easier – and smoking makes it more likely that you’ll experience birth complications.
Common myths about NRT in pregnancy
Isn’t the nicotine in NRT addictive? Am I just replacing one form of addiction for another?
Cigarettes are addictive but NRT is not. This is because nicotine is delivered to the brain more slowly with NRT. Nicotine reaches the brain very quickly with smoking and this is what makes smoking so addictive. You should have no problem coming off NRT once you have finished the course of treatment. If you replace all cigarettes with NRT, after a while you’ll find your brain becomes less bothered about nicotine and you’ll feel a lot less need to smoke.
Could I ‘overdose’ on nicotine if I use two NRT products together?
No, NRT gives you less nicotine than smoking but enough to help with your withdrawal symptoms and cravings. Even when using two NRT products together, you’re unlikely to get more nicotine than you did from smoking. You don’t overdose on nicotine when smoking because your body tells you if you are taking in too much - the same goes for NRT. You can control how often you ‘top up’ on nicotine when using fast-acting NRT - see 'How to use NRT' for more information. We’ll help you to spot the signs if you are getting more nicotine than you need.
Isn’t it better to quit without NRT?
Stopping smoking is most important for you and your baby’s health. The best way for you to quit is whatever works and helps you and your baby to lead smoke-free lives. If you can stop without using NRT then that is great. However, using NRT should make quitting easier for you. Having nicotine from NRT in your system does not mean that you are still a smoker – what matters is that you’ve completely stopped using tobacco. It’s better to cut out all smoking as soon as possible with NRT than to keep trying and failing to quit without it. And using NRT won’t make it more likely that you’ll re-start smoking - but having a cigarette every now and again will.
If you have any concerns at all about using NRT that we’ve not dealt with on this website, please bring these up with your Stop Smoking Practitioner at the earliest opportunity.