As reported by USA Today, September 30, 2008.

Nicotine Gum Helps Pregnant Women Cut Back on Cigarettes

By Liz Szabo

Nicotine gum doesn't help pregnant smokers quit smoking, but it may help them smoke fewer cigarettes — reducing their risk of having a premature or low-birth-weight baby, according to a small study.

The study is one of the few to examine the effect of nicotine replacement in pregnancy. Nicotine-replacement products haven't been approved for pregnant women, although 12% of expectant mothers smoke.

The nearly 200 women in the study smoked an average of 18 cigarettes a day before pregnancy and 10 a day in the week before beginning the study, which was published today in Obstetrics & Gynecology. Those given nicotine gum cut back by five or six cigarettes each day, while those who were given placebos cut back by three or four cigarettes a day.

Doctors also noticed that babies born to moms who chewed nicotine gum were less likely to need intensive care and had shorter hospital stays, although researchers say it's possible that this could have been due to chance.

Avoiding tobacco is one of the most important things a woman can do to protect her baby, experts say. Smoking doubles the risk of low birth weight and prematurity, and causes up to 10% of infant deaths, according to the study.

Researchers randomly assigned women to receive either nicotine gum or placebos. All women also were offered six counseling sessions.

About 85% of women in the study wanted to quit smoking, and they had tried to quit about three times, says study author Cheryl Oncken, an associate professor at the University of Connecticut School of Medicine.

It's possible that nicotine gum's dramatic benefits for patients may come from the small number of women in the study, says the March of Dimes' Diane Ashton. Although the study is promising, researchers will need to perform much larger studies to show that nicotine gum is really safe during pregnancy.

Although nicotine has risks, Oncken says it may be safer than tobacco smoke, which contains carbon monoxide and thousands of chemicals.

The American Cancer Society's Thomas Glynn notes that there are very few randomized trials — considered the gold standard in medicine — about nicotine replacement in pregnancy.

Glynn says the study is also significant because it focused on women with some of the highest smoking rates: those with low incomes, little education and a history of mental health problems. About 27% of pregnant women without a high school diploma smoke, compared with 2% of those with a college degree, according to the Campaign for Smoke-Free Families.