title: Prescribing of nicotine replacement therapy in and around pregnancy: a population-based study using primary care data.
abstract: BACKGROUND
  Licensing arrangements for nicotine replacement therapy (NRT) in the UK were broadened in 2005 to allow prescribing to pregnant smokers. However, estimates of NRT prescribing in pregnant females in the UK are currently lacking.
  
  
  OBJECTIVE
  To assess trends in NRT prescribing around pregnancy, and variation in prescribing by maternal characteristics.
  
  
  METHODS
  Population-based descriptive study using pregnancy data from The Health Improvement Network primary care database, 2001-2012.
  
  
  METHODS
  NRT prescriptions were identified during pregnancy and in the 9 months before and after. Annual prescribing prevalence was calculated. Logistic regression was used to assess females' likelihood of receiving prescriptions by maternal characteristics.
  
  
  RESULTS
  Of 388 142 pregnancies studied, NRT was prescribed in 7551 for an average duration of 2 weeks. The prescribing prevalence of NRT increased from 0.03% (0.7% in smokers) in 2001 to 2.6% (11.4% in smokers) in 2005, after which it remained stable. Prescribing prevalence of NRT before and after pregnancy was half the prevalence during pregnancy. The odds of prescribing NRT during pregnancy in smokers increased with socioeconomic deprivation (OR = 1.29, 95% CI = 1.15 to 1.45 in the most compared with the least deprived group). Prescribing was 33% higher in pregnant smokers with asthma (OR = 1.33, 95% CI = 1.22 to 1.45) and mental illness (OR = 1.33, 95% CI = 1.23 to 1.44) compared with smokers without these diagnoses.
  
  
  CONCLUSIONS
  NRT prescribing is higher during pregnancy compared with before and after, and is higher in smokers from more socioeconomically deprived groups, those with asthma or those diagnosed mental illness.
authors.affiliation: Division of Primary Care, and doctoral student, Division of Epidemiology and Public Health, University Of Nottingham, Nottingham, UK.
authors.forename: Nafeesa N
authors.initials: NN
authors.lastname: Dhalwani
authors.affiliation: Division of Epidemiology and Public Health, University Of Nottingham, Nottingham, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Szatkowski
authors.affiliation: Division of Primary Care, University Of Nottingham, Nottingham, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Coleman
authors.affiliation: Division of Epidemiology and Public Health, University Of Nottingham, Nottingham, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Fiaschi
authors.affiliation: Division of Epidemiology and Public Health, University Of Nottingham, Nottingham, UK.
authors.forename: Laila J
authors.initials: LJ
authors.lastname: Tata
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011320:Primary Health Care; D012107:Research Design; D012907:Smoking / Q000009:adverse effects / Q000188:drug therapy* / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices / Q000639:trends; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D018722:Nicotinic Agonists
keywords: nicotine replacement therapy; pregnancy; prescribing; smoking cessation