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:  In-Data-Review    
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     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:  -     Revised Date:  -    
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.
Affiliation:
UK Centre for Tobacco Control Studies, Division of Primary Care, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK, 3 Centres Collaboration, Women's and Children's Program, Monash Medical Centre, Victoria, Australia and UK Centre for Tobacco Control Studies Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK.
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