[How can we help pregnant women stop smoking?]

Smoking is a behavior maintained and enhanced by nicotine-induced dependence. Despite awareness and knowledge of the associated health risks many smokers find it considerably difficult to quit. Nicotine withdrawal symptoms and undesirable effects such as depression and weight gain serve as justification for the numerous unsuccessful attempts in smoking cessation. Yet, we have now come to the end of empiricism. Treatments that have been shown to work exist and international evidence-based recommendations for cessation interventions have been established: brief advice, nicotine replacement therapy and behavioral and cognitive therapies. Measuring nicotine dependence using the Fagerström test helps to define the therapeutic strategy. Blood cotinine level can be measured during pregnancy. It is obvious that therapies can only work for smokers who are motivated to stop smoking. Before reaching the decision to quit, the smoker goes through a process during the course of which the role of information and advice from health professionals are paramount. When they became pregnant, young women are not necessary ready to quit. For many of them, pregnancy is sufficient motivation enabling them to stop smoking, but for thirty percent of them, probably the most dependent, it would be very difficult to stop without a specific program of help.