Oncken C A, Kranzler H R
Department of Medicine, University of Connecticut School of Medicine, Farmington 06030, USA.
Drug Alcohol Rev. 2003 Jun;22(2):191-202. doi: 10.1080/09595230100100633.
Smoking during pregnancy is a significant public health concern. Maternal smoking increases the risk of spontaneous abortion, low birth weight, premature delivery, sudden infant death syndrome and learning and behavioral problems in the offspring. Unfortunately, the majority of pregnant women do not quit smoking during pregnancy. Although pharmacotherapy may improve smoking cessation rates in pregnancy, very few studies exist that have studied the safety and efficacy of medications to treat pregnant smokers. This article reviews the available safety and efficacy data for the use in pregnancy of the five first-line therapies and two second-line therapies that are recommended for smoking cessation in non-pregnant smokers. Other promising nicotine replacement therapies are also reviewed. Ultimately, the choice whether to use pharmacotherapy for smoking cessation should be made jointly by the pregnant smoker and her health care provider. This article reviews factors that may be considered when prescribing pharmacotherapy to pregnant smokers (i.e. the role of behavioral counseling, identification of appropriate patients, potential advantages and disadvantages of each of the pharmacotherapies, proposed monitoring strategies, dose and duration and goals of treatment). More research regarding the safety and efficacy of pharmacotherapy during pregnancy is needed to define the risk/benefit profile of each medication for use in smoking cessation in pregnant women.
孕期吸烟是一个重大的公共卫生问题。孕妇吸烟会增加自然流产、低出生体重、早产、婴儿猝死综合征以及后代学习和行为问题的风险。不幸的是，大多数孕妇在孕期并未戒烟。尽管药物疗法可能会提高孕期戒烟率，但很少有研究探讨治疗孕期吸烟女性所用药物的安全性和有效性。本文综述了推荐用于非孕期吸烟者戒烟的五种一线疗法和两种二线疗法在孕期使用的现有安全性和有效性数据。还对其他有前景的尼古丁替代疗法进行了综述。最终，是否使用药物疗法戒烟应由孕期吸烟女性及其医疗保健提供者共同决定。本文综述了为孕期吸烟女性开处方药物疗法时可能考虑的因素（即行为咨询的作用、合适患者的识别、每种药物疗法的潜在优缺点、建议的监测策略、剂量、疗程以及治疗目标）。需要开展更多关于孕期药物疗法安全性和有效性的研究，以明确每种药物用于孕妇戒烟的风险/获益情况。
