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  • 1 July 2020 to 14 February 2021
  • Project No: 477
  • Funding round: FR19

Smoking in pregnancy harms babies and their mothers, causing serious pregnancy complications; miscarriage and stillbirth (baby deaths in the womb); smaller, and unhealthy babies born early.

For healthy babies and mothers, stopping smoking before or very early in pregnancy is crucial. Despite trying, many pregnant women cannot stop or only do so for short periods before re-starting smoking. Although babies are healthiest when pregnant women stop smoking completely, there is strong evidence that when women cut down their smoking, babies are healthier compared to those of women who continued to smoke as usual throughout their pregnancy.

Nicotine makes cigarettes addictive. Nicotine replacement therapy (NRT) provides nicotine without the harmful substances in cigarette smoke. NRT can help women stop smoking when it is accompanied by behavioural support which gives them advice and help with quitting. The NHS tells pregnant women using NRT not to smoke ‘even a puff’. However, research suggest that sometimes allowing people to continue smoking whilst using NRT makes them smoke fewer cigarettes and can even help them stop smoking.

For this study we will search for research papers describing studies where people, not specifically pregnant women, use NRT but do not completely stop smoking. We will group the studies’ findings together to see how heavily people smoke and how much nicotine they take in when they use NRT in this manner. We aim to discover whether how heavily people smoke or their nicotine intake is influenced by, the type of NRT they use or how they are instructed to use NRT. For example, being told to continue smoking as normal or to cut down their smoking.

Project findings will help researchers decide on how NRT, even with some smoking at the same time, might be best used to help pregnant women to stop or cut down smoking.


Tim Coleman, Katarzyna Campbell, Ross Thomson, Lucy Phillips (Nottingham)


Amount awarded: £32 890.00

Projects by themes

We have grouped projects under the five SPCR themes in this document

Evidence synthesis working group

The collaboration will be conducting 18 high impact systematic reviews, under four workstreams.