Please note this application is under active development. If you spot any errors or something isn't working, please contact us at evidence.service@wales.nhs.uk.

Smoking Cessation Interventions in Pregnancy and Postpartum Care

Likis FE et al (2014)

Agency for Healthcare Research and Quality - AHRQ Publication No. 14-E001-EF

Evidence Categories

  • Care setting: Healthcare Setting
  • Population group: Pregnancy/ post-partum
  • Intervention: Multicomponent Interventions
  • Intervention: Other Psychosocial Therapies
  • Intervention: Cognitive Behaviour Therapy
  • Intervention: Self-Help Materials
  • Intervention: Motivational Interviewing
  • Intervention: Behaviour Support
  • Intervention: Nicotine Replacement Therapy
  • Outcome: Smoking cessation
  • Outcome: Smoking Relapse Prevention

Type of Evidence

Systematic Review

Aims

The Vanderbilt Evidence-based Practice Center systematically reviewed evidence about smoking cessation interventions in pregnant and postpartum women.

Findings

"The authors included 59 unique studies reported in 72 publications. Of the 56 RCTs, 13 were good, 15 fair, and 28 poor quality. Studies evaluated counseling-based interventions, educational materials, nicotine replacement therapy (NRT), peer support, multicomponent interventions, and other unique interventions. Multicomponent approaches were most likely to be effective, but results were inconsistent. In the meta-analysis, incentives demonstrated the strongest effect; other components with a greater than 80-percent likelihood of success were feedback about biologic measures, information, personal followup, NRT, and quit guides. Findings regarding infant outcomes were inconsistent or did not reach statistical significance. No serious harms were identified in four studies that reported adverse events."

Conclusions

Across interventions, data are sparse to evaluate sustained cessation among pregnant and postpartum women. This review suggests that approaches that combine multiple components will have the best likelihood of success. Selecting which components to include is more complex and should be based on the particular considerations of the clinical setting, including patient characteristics and resource allocation, but incentives demonstrated the greatest effect among components studied. Infant outcomes are limited to data collected at time of birth; no studies assessed longer term or child outcomes. Harms data were rarely reported.