Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review

Aims: In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re-start smoking at time-points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected...

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Main Authors: Jones, Matthew, Lewis, Sarah, Parrott, Steve, Wormall, Stephen, Coleman, Tim
Format: Article
Language:English
Published: Wiley 2016
Subjects:
Online Access:https://eprints.nottingham.ac.uk/32419/
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author Jones, Matthew
Lewis, Sarah
Parrott, Steve
Wormall, Stephen
Coleman, Tim
author_facet Jones, Matthew
Lewis, Sarah
Parrott, Steve
Wormall, Stephen
Coleman, Tim
author_sort Jones, Matthew
building Nottingham Research Data Repository
collection Online Access
description Aims: In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re-start smoking at time-points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected time-points during the postpartum period (secondary analysis). Methods: Trials identified from two Cochrane reviews plus searches of Medline and EMBASE. Twenty-seven trials were included. The included trials were randomized or quasi-randomized trials of within-pregnancy cessation interventions given to smokers who reported abstinence both at end of pregnancy and at one or more defined time-points after birth. Outcomes were validated biochemically and self-reported continuous abstinence from smoking and 7-day point prevalence abstinence. The primary random-effects meta-analysis used longitudinal data to estimate mean pooled proportions of re-starting smoking; a secondary analysis used cross-sectional data to estimate the mean proportions smoking at different postpartum time-points. Subgroup analyses were performed on biochemically validated abstinence. Results: The pooled mean proportion re-starting at 6 months postpartum was 43% [95% confidence interval (CI) = 16–72%, I2 = 96.7%] (11 trials, 571 abstinent women). The pooled mean proportion smoking at the end of pregnancy was 87% (95% CI = 84–90%, I2 = 93.2%) and 94% (95% CI = 92–96%, I2 = 88%) at 6 months postpartum (23 trials, 9262 trial participants). Findings were similar when using biochemically validated abstinence. Conclusions: In clinical trials of smoking cessation interventions during pregnancy only 13% are abstinent at term. Of these, 43% re-start by 6 months postpartum.
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spelling nottingham-324192020-05-08T12:30:33Z https://eprints.nottingham.ac.uk/32419/ Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review Jones, Matthew Lewis, Sarah Parrott, Steve Wormall, Stephen Coleman, Tim Aims: In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re-start smoking at time-points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected time-points during the postpartum period (secondary analysis). Methods: Trials identified from two Cochrane reviews plus searches of Medline and EMBASE. Twenty-seven trials were included. The included trials were randomized or quasi-randomized trials of within-pregnancy cessation interventions given to smokers who reported abstinence both at end of pregnancy and at one or more defined time-points after birth. Outcomes were validated biochemically and self-reported continuous abstinence from smoking and 7-day point prevalence abstinence. The primary random-effects meta-analysis used longitudinal data to estimate mean pooled proportions of re-starting smoking; a secondary analysis used cross-sectional data to estimate the mean proportions smoking at different postpartum time-points. Subgroup analyses were performed on biochemically validated abstinence. Results: The pooled mean proportion re-starting at 6 months postpartum was 43% [95% confidence interval (CI) = 16–72%, I2 = 96.7%] (11 trials, 571 abstinent women). The pooled mean proportion smoking at the end of pregnancy was 87% (95% CI = 84–90%, I2 = 93.2%) and 94% (95% CI = 92–96%, I2 = 88%) at 6 months postpartum (23 trials, 9262 trial participants). Findings were similar when using biochemically validated abstinence. Conclusions: In clinical trials of smoking cessation interventions during pregnancy only 13% are abstinent at term. Of these, 43% re-start by 6 months postpartum. Wiley 2016-05-09 Article PeerReviewed application/pdf en cc_by_nc https://eprints.nottingham.ac.uk/32419/1/Jones_et_al-2016-Addiction.pdf Jones, Matthew, Lewis, Sarah, Parrott, Steve, Wormall, Stephen and Coleman, Tim (2016) Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review. Addiction, 111 (6). pp. 981-990. ISSN 1360-0443 Meta-analysis postpartum period pregnancy randomized controlled trial re-starting smoking smoking smoking cessation smoking cessation interventions systematic review tobacco http://onlinelibrary.wiley.com/doi/10.1111/add.13309/abstract doi:10.1111/add.13309 doi:10.1111/add.13309
spellingShingle Meta-analysis
postpartum period
pregnancy
randomized controlled trial
re-starting smoking
smoking
smoking cessation
smoking cessation interventions
systematic review
tobacco
Jones, Matthew
Lewis, Sarah
Parrott, Steve
Wormall, Stephen
Coleman, Tim
Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_full Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_fullStr Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_full_unstemmed Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_short Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_sort re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
topic Meta-analysis
postpartum period
pregnancy
randomized controlled trial
re-starting smoking
smoking
smoking cessation
smoking cessation interventions
systematic review
tobacco
url https://eprints.nottingham.ac.uk/32419/
https://eprints.nottingham.ac.uk/32419/
https://eprints.nottingham.ac.uk/32419/