Rationale for treating pregnant smokers with nicotine patches

QUESTION: One of my pregnant patients smokes about 20 cigarettes daily. She has tried several times through behavioural therapy to quit, but has been unsuccessful. What do you recommend? ANSWER: You might consider nicotine replacement therapy and concurrent behavioural counseling. With this therapy, nicotine levels in the body are typically lower than during heavy smoking, and the thousands of other toxins emitted by cigarette smoke, such as carbon monoxide and hydrogen cyanide, are avoided.