Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
In an ideal world, none of us would ever have smoked, and no one would have been making smoking look cool and tempted us to do so.
Since we do not live in such a world, a question arises with regard to women who smoke and who are contemplating pregnancy, currently pregnant or breastfeeding. The evidence is quite clear that stopping smoking would be in these women's best interests and also the best interests of her children (perhaps as yet unborn or unconceived). This is much easier to say than to do. Many programs exist to help people stop smoking. These programs have fairly poor rates of success.
Ssome medications used in some cessation programs are not safe to use while pregnant (although, of course, neither are cigarettes, so there is a balance to be found). Most are not well studied. It would be best to make efforts to stop smoking before conceiving, particularly since many women who quit smoking while pregnant relapse after delivery. This is hardly surprising. Nicotine is incredibly effective at reducing anxiety, and very little is as anxiety or anger provoking (both major triggers for smoking) as having a newborn. Women who breastfeed are less likely to relapse than women who formula feed; this also makes sense, in that breastfeeding hormones can be strongly anti-anxiety and, for some mothers, euphoric.
I have not smoked, so I have never had to quit. From reading, and from the experiences of my friends, it is clear that quitting is difficult and generally one has to try many different things before successfully quitting permanently. The patch can help, as can gum; over-the-counter nicotine replacements such as the patch and gum are certainly no more dangerous than cigarettes, although combining these with cigarettes could cause problems. Bupropion made a difference for at least one woman I know. While I have been told by one woman she was advised to stop breastfeeding so she could take Wellbutrin, that seems to have been, as usual, unnecessary advice; here is what Thomas Hale and La Leche have to say about a number of medications including bupropion. Bupropion may impact milk supply, which is worth taking into consideration in deciding whether to use it; surely no one would wean because of a possible risk of reduced milk supply.
While caffeine consumption by pregnant and breastfeeding women is not particularly dangerous (and probably not dangerous at all in moderation), smokers might think hard about stopping all caffeine first; caffeine tends to accelerate cravings, by increasing the euphoria felt from smoking.
If you have a baby, and you still smoke, please do not let anyone discourage you from breastfeeding on that account. Here is a discussion of why breastfeeding is perhaps even more important for a baby exposed to cigarette smoke.
Copyright 2006 by Rebecca Allen.
Created February 1, 2006 Updated March 8, 2006