Recruiting patients

Lead Investigator

Professor Tim Coleman

Professor of Primary Care

University of Nottingham



What is the study about?

Nicotine replacement therapy (NRT), such as nicotine patches, used with behavioural support is effective in helping non-pregnant people to quit smoking. There is less evidence of NRT being effective in pregnancy. Nicotine preloading (starting NRT before the quit date, while gradually reducing the amount of cigarettes smoked), has been found further to help people who were not pregnant to quit smoking. NHS currently advises that pregnant women should not use NRT if they smoke, ‘not even a puff’, however some research suggests that allowing women to preload (smoke and use NRT at the same time) could help them stop smoking more successfully.

The SNAP3 trial will carefully test if relaxing the ‘not a puff’ rule in three different ways could help pregnant women to quit or not.

SNAP3 is looking to find out if the following three ways of using NRT in pregnancy can help women stop smoking, when compared to usual care: 

(1) NRT use for preloading before quit date (QD), 

(2) NRT use in recovery from brief lapses (slip-ups) to smoking 

(3) NRT use for smoking reduction, with the aim to induce cessation in those unable to quit.

The intervention will be delivered alongside standard NHS stop smoking support, and compared to standard support alone.

The trial is designed to be practical and run alongside ANY stop smoking support provided locally. 

Who can take part in the study?

Pregnant women (<25 weeks gestation) who smoke 5+ cigarettes per day

What is being tested in the study?

Behavioural intervention in which women are supported to use NRT in a novel way (preloading/lapse recovery and cutting down) in addition to usual care (see below)

What is this being compared to?

Usual care – support from stop smoking services in local areas and NRT (only)

What are we trying to find out?

If support to use NRT in the three novel ways in pregnancy (described above) can help women stop smoking, when compared to usual care

How many patients do we need?

1430 patients


National Institute for Health and Care Research - Health Technology Assessment (NIHR - HTA)

Useful links