It’s impossible to dispute the fact that cigarette smoking is harmful to one’s health. Women who smoke during pregnancy risk harming the developing fetus, especially the developing brain. There are nicotine replacements available that eliminate the toxic smoke that comes from a cigarette but nicotine itself is a neurotoxin. Recent studies explored the pros and cons of various tobacco alternatives.

Each year in the United States, more than half a million babies are born to women who smoked during pregnancy. Nicotine is disruptive to brain development, according to animal studies. It interferes with the chemical signals in a developing fetal brain in a way that’s described as slamming a big chunk of wood down on a piano during the playing of a concerto. The children born to smokers are more likely to develop disorders of conduct and learning, such as ADHD.

Smoking is a hard habit to quit. A 2012 study conducted in the United Kingdom involved 1,000 smokers who were all counseled about the dangers of smoking during pregnancy. Some women were given the adhesive nicotine skin patch and others were given placebo patches. The quit rate for both groups was the same by the end of pregnancy. About 93 percent of the patch users did not use them as directed.

A second study, conducted at the University of Connecticut Health Center, found better results with nicotine gum. The gum didn’t help women quit smoking altogether during pregnancy but it did reduce the number of cigarettes smoked. By smoking less, the overall fetal exposure to nicotine and other toxins associated with smoking was reduced and the babies’ birth weights rose to healthier levels.

Cigarette smoke contains carbon monoxide, lead, and arsenic, all chemical elements that damage cells in a developing fetal brain. There are thousands of other chemical compounds in cigarette smoke that threaten fetal health, too.

The developing fetal brain can repair some of the damage done by nicotine and other toxins of smoking when there is a break between doses of the toxins. Women are urged to reduce the number of cigarettes smoked during pregnancy or stop smoking altogether.

If quitting proves impossible, nicotine gum, lozenges, sprays, and inhalers are preferred over patches. The patches supply a non-stop supply of nicotine to a mother’s bloodstream and into her child’s. This continuous supply of neurotoxins does not give the developing fetus the opportunity to recover between nicotine doses.

Source: Coleman, Tim, MD, et al. “A Randomized Trial of Nicotine-Replacement Therapy Patches in Pregnancy.” The New England Journal of Medicine. Massachusetts Medical Society. Mar 1, 2012. Web. Dec 4, 2013.