Which medication is considered a first-line therapy for smoking cessation in pregnant women?

Nicotine replacement therapy (NRT) is favored as a first-line therapy for smoking cessation in pregnant women due to its established safety profile when used correctly and its effectiveness in aiding cessation. NRT includes products like patches, gum, lozenges, and inhalers that deliver controlled doses of nicotine without the harmful tar and gases produced by smoking.

Research has shown that nicotine replacement can significantly increase the chances of successfully quitting smoking, which is crucial during pregnancy since tobacco use can lead to adverse outcomes such as low birth weight and premature birth. While the absolute benefits vs. risks of using NRT during pregnancy are always considered, the general consensus among health providers is that the potential benefits of helping a pregnant woman quit smoking outweigh the risks associated with NRT, particularly compared to the risks of continued smoking.

In contrast, other options like bupropion and varenicline are not typically recommended for pregnant women due to limited data on safety and potential risk to the fetus. SSRIs are primarily used for depression and anxiety management and are not recognized for efficacy in smoking cessation.