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Review
. 2012 May;58(5):525-7.

Smoking cessation therapy during pregnancy

Alex M Cressman, Anna Pupco, Eunji Kim, Gideon Koren, Pina Bozzo
Review

Smoking cessation therapy during pregnancy

Alex M Cressman et al. Can Fam Physician. 2012 May.

Abstract
in English, French

Question: Despite being highly motivated to quit, many of my patients struggle with smoking cessation during pregnancy. Can you comment on the current treatment options and discuss their safety and efficacy during pregnancy?

Answer: Given the considerable and well-documented adverse effects of antenatal smoking on mother and fetus, pharmacotherapy for smoking cessation should be considered. Available medications include nicotine replacement therapy, sustained-release bupropion, and varenicline. Nicotine replacement therapy and bupropion do not appear to increase the risk of major malformations; however, there is currently limited evidence on the use of varenicline during pregnancy. Given that these agents are only marginally successful in smoking cessation, their use should always be accompanied by behavioural counseling and education to maximize quit rates.

Question Même si elles sont très motivées à arrêter de fumer, beaucoup de mes patientes enceintes éprouvent de la difficulté à y arriver. Pouvez-vous nous dire ce que vous pensez des choix de traitements actuels, et traiter de leur sécurité et de leur efficacité durant la grossesse?

Réponse Étant donné les effets indésirables considérables et bien documentés du tabagisme pendant la grossesse sur la mère et le fœtus, il y a lieu d’envisager une pharmacothérapie pour arrêter de fumer. Les médicaments disponibles incluent les thérapies de substitution de la nicotine, le bupropion à libération prolongée et la varénicline. Les thérapies de substitution de la nicotine et le bupropion ne semblent pas augmenter le risque de malformations majeures; par ailleurs, les données scientifiques sont limitées sur l’utilisation de la varénicline durant la grossesse. Étant donné que ces agents n’ont qu’un taux de réussite marginal pour arrêter de fumer, leur utilisation devrait toujours être accompagnée par un counseling comportemental et de la formation pour améliorer les taux d’abandon.

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