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Relative to smoking, blood nicotine levels are lower when using NRT, nicotine is delivered more slowly, and exposure to the harmful substances contained in tobacco smoke, in particular CO, is avoided 29,40,41

4 Clinicians should be proactive and directly ask patients about their tobacco use at each prenatal visit and assess their smoking history, including the number of pack-years smoked

There is no safe level of tobacco consumption and all tobacco products are harmful (World Health Organization, 2025)

PMID 18851907