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Smoking during pregnancy has adverse outcomes such as low birth weight. Although nicotine replacement therapy (NRT) is effective in other smoking populations, this approach has not been shown to work during pregnancy. However, prior studies were short, involved relatively low, inflexible daily doses of nicotine, and had poor adherence. In this randomized, double blind, placebo-controlled trial, investigators in France assessed the efficacy of 16-hour nicotine patches (dose range, 10–30 mg daily; adjusted according to saliva cotinine levels) started between 9 and 20 weeks' gestation in 402 pregnant smokers.
Adherence was similar in both groups (about 85%). Complete abstinence from smoking was achieved by 5.5% in the NRT group and 5.1% in the …