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Another important finding of this study was that smoking exposure within three months before pregnancy, but with cessation during the pregnancy, had the similar risk of birth congenital anomalies compared with persistent smokers before and during pregnancy

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CDER updated NRT labeling in 2013 to permit NRT use while smoking (also known as dual use) as part of the journey to cessation, and permits sustained use for relapse prevention for a lifetime if need be (36)