Document Detail


Efficacy and safety of nicotine replacement therapy for smoking cessation in pregnancy: systematic review and meta-analysis.
MedLine Citation:
PMID:  21054620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To determine the efficacy and safety of nicotine replacement therapy (NRT) with or without behavioural support when used to support smoking cessation in pregnancy.
DESIGN, SETTING AND PARTICIPANTS: A systematic review of randomized controlled trials (RCTs) in which NRT was used with or without behavioural support to promote smoking cessation; trials providing unequal behavioural support to different trial groups were excluded.
MEASUREMENTS:
EFFICACY: self-reported smoking cessation in later pregnancy, validated where possible by biochemical measures with appropriate cut-points; infants' safety: mean and low birth weights (LBW), preterm birth, fetal demise and neonatal intensive care unit (NICU) admissions.
FINDINGS: Five trials, enrolling 695 pregnant, regular smokers were included in the review. The pooled risk ratio (RR) and 95% confidence Interval (CI) for smoking cessation in later pregnancy after using NRT was 1.63 (0.85, 3.14). Subgroup analysis comparing studies at lower risk of bias (placebo-RCTs) with those at higher risk of bias (non-placebo-RCTs) found that efficacy estimates varied with trial design [RR (95% CI) for cessation in placebo-RCTs 1.17 (0.83, 1.65) versus 7.81 (1.51, 40.35) for non-placebo-RCTs]. Five of the seven safety outcomes were more positive among infants born to women who had used NRT, but none of the observed differences between trial groups reached statistical significance.
CONCLUSIONS: There is currently insufficient evidence to determine whether or not nicotine replacement therapy is effective or safe when used in pregnancy for smoking cessation; further research and, in particular, placebo-randomized controlled trials are required.
Authors:
Tim Coleman; Catherine Chamberlain; Sue Cooper; Jo Leonardi-Bee
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2010-11-04
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  106     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-05-27     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  52-61     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Behavior Therapy
Combined Modality Therapy
Female
Fetal Mortality
Humans
Nicotine / adverse effects,  therapeutic use*
Nicotinic Agonists / adverse effects,  therapeutic use*
Patient Compliance / statistics & numerical data
Pregnancy
Pregnancy Complications / prevention & control*
Premature Birth / epidemiology
Randomized Controlled Trials as Topic
Smoking / prevention & control*
Smoking Cessation / methods*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//British Heart Foundation; //Medical Research Council; //Department of Health; //Cancer Research UK
Chemical
Reg. No./Substance:
0/Nicotinic Agonists; 54-11-5/Nicotine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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