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This week we respond to questions about drinking alcohol in pregnancy, and smoking cessation.

Dear HOUSE Calls,  

I am 8 weeks pregnant and wonder if you think a occasional glass of wine is OK.  I’ve heard that alcohol in small quantities may be safe.

That is a great question, and one many of our patients ask during prenatal care.

So, the major issue is fetal alcohol syndrome, which is generally associated with large quantities of alcohol.  However, we know that alcohol is toxic to the developing brain, and we don’t know of a level that is known to be safe.  On the other hand, we don’t know of harm associated with low level consumption.  Most doctors will advise you to avoid alcohol during pregnancy.

Let’s think of it this way:  we like to avoid drugs and other potential toxins during pregnancy—even drugs that are probably safe.  With alcohol, we have a known toxin. If it is not important for the health of the women or the fetus, why expose the fetus to the risk of a known toxin? We also suspect that the level of exposure is related to the fetal effects. It might be hard to measure if small amounts of alcohol were associated with mild changes to behavior, development, and intelligence later in life.  So we think it is safest to avoid alcohol while you’re pregnant.

Dear HOUSE Calls,

I want to quit smoking, and I would like some help. I heard that the state has a free program called the quit line. How do I access that service? Can I also get medication like nicotine patches to help me quit? Thank you.

Thank you for the question. We have both good news and some not so good news for you. First, we congratulate on wanting to quit, and although it is hard, making a firm decision and getting support for the decision doubles your chances of being successful. If you add in medication like nicotine patches, you triple your chances for success.

It is true that North Carolina has a free program to help smokers quit smoking. The program is called QuitlineNC, and it provides free counseling support, in both Spanish and English, 24 hours a day seven days a week by simply calling 1-800-QUIT-NOW. Trained counselors will help you implement a quit smoking plan that will include support from family and friends, activities to do other than smoking, and ways to avoid those cues that seem to trigger people to smoke.  For the last few months, QuitlineNC even has had patches to give out like the ones you want, all free of charge. This program has resulted in thousands of smokers calling to seek such support.

Unfortunately, the bad news is that the money for this free program is running out, and funding for the Quitline is in jeopardy in the state budget. If things go the way they seem to be headed, after the end of June, unless you are a state employee, you will not be able to get the free patches, and may not have access to the Quitline. We would encourage you to start as soon as possible. Good luck.

HOUSE Calls is a weekly column by Dr. Adam Zolotor, Dr. Adam Goldstein, and Dr. Cristy Page on behalf of YOUR HEALTH and the UNC Department of Family Medicine. Adam Goldstein is also Professor, Family Medicine, Director, with the UNC Tobacco Prevention and Evaluation Program.

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