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QUESTION: Several years ago you argued in favour of trying nicotine replacement therapy during pregnancy. The Ontario Medical Association recommended the same. Are there any studies now to show that the patch works? ANSWER: A large randomized, blinded study from Denmark has recently shown that the rate of quitting smoking during pregnancy using the nicotine patch is very low and not different from the rate among those given placebo. Preliminary data suggest that women who cannot quit smoking after the first trimester metabolize nicotine rapidly and that this could be a mechanism for their failure to quit.