Dr. Phelan further explains a woman first needs to understand why she smokes, what triggers it. Is it merely being around others who smoke? Is it because she's bored? Is it because she's stressed? Then she needs to give herself an alternative activity to smoking. For example, if she smokes with her colleagues during coffee breaks, she may instead find some non-smoking co-workers to hang out with for those mini R&R sessions. If boredom is the trigger, go for a walk. And if it's an oral fixation, chomp on a celery or carrot stick, suggests Dr. Phelan. For those smokers who are stressed, meditation, or another relaxing activity, may be the answer.
If you live with a smoker, with temptation literally lurking around the corner, Dr. Phelan suggests the couple declare a smoke-free zone of the house.
While doctors and midwives may be the first line of defense for a pregnant smoker, there are other counseling resources available if a woman feels she needs additional support. Hospitals often offer these services, and some corporations and HMOs offer assistance through wellness programs.
The Patch and Gum:Are They Safe?
ACOG recommends that pregnant smokers not consider using nicotine replacement products—the patch, gum, and a prescription spray—unless non-pharmacological treatment, such as counseling, has already failed. The safety and effectiveness of these products for pregnant women are still being evaluated. Dr. Phelan notes that, "Usually women who smoke a pack a day or less can do it behaviorally," sans smoking cessation products.
It's the hard-core smokers who might need the additional assistance of nicotine replacement to stop smoking. "Although it's not perfectly safe, it is probably safer than smoking because you're dealing with a pure nicotine and you're not dealing with all the other chemicals and the carbon monoxide and the other effects [of smoking]," notes Phelan.