Efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers: a meta‐analysis

Myung, S-K; Ju, Woong; Jung, H-S; Park, C-H; Oh, S-W; Hg, Seo; Hs, Kim

doi:10.1111/j.1471-0528.2012.03408.x

Cited by 46 publications

(33 citation statements)

References 25 publications

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“…13 A review of Nicotine Replacement Therapy (NRT) reported no difference in symptoms such as headache, skin irritation, dizziness, nausea, heartburn, fatigue, palpitation, reduced sensation, increased morning sickness symptoms, and aggravation of postnatal depression, compared to the placebo groups. 14 Conversely, there was some evidence that positive outcomes such as higher mean birthweight and lower preterm delivery occurred in the NRT group. Stronger evidence is required but current data indicates that NRT in pregnant women is safe and could result in higher mean birth weights and lower rates of preterm delivery.…”

Section: Editorialmentioning

confidence: 99%

“…14 Similarly, a systematic review 15 investigating NRT as an adjunct to behavioural support found that when studies without randomization were excluded, there was no significant difference between the smoking cessation rate for the NRT and the placebo group. The low adherence rate in the treatment group may explain these results and may have occurred because the mothers perceived NRT to be harmful to the foetus.…”

Section: Editorialmentioning

confidence: 99%

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Are we missing an opportunity to improve smoking cessation rates for pregnant women?

Siqueira¹

2017

JHD

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Section: Editorialmentioning

confidence: 99%

Section: Editorialmentioning

confidence: 99%

Are we missing an opportunity to improve smoking cessation rates for pregnant women?

Siqueira¹

2017

JHD

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“…weight with nicotine replacement therapy, one of which also found decreased incidence of low birth weight and preterm delivery with therapy (27). For pregnancy, transdermal nicotine is classified as FDA Category D, and shorteracting therapies are classified as FDA Category C. Nicotine concentrates in breast milk, with a 2.9:1 ratio with maternal serum (28).…”

Section: Key Points/clinical Pearlsmentioning

confidence: 99%

Nicotine Replacement Therapy

Flowers

2016

AJP Residents' Journal

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“…2 First, we are very sorry that we did not include in our review Coleman et al's review, 3 which was published in early 2011. We should have searched and reviewed previous literature on this issue more thoroughly.…”

Section: Sirmentioning

confidence: 99%

Authors' response to: Efficacy of nicotine replacement therapy in pregnancy

Myung¹,

Hg²

2013

BJOG

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We appreciate the letter of Coleman et al. 1 in response to our report in BJOG.2 First, we are very sorry that we did not include in our review Coleman et al.'s review, 3 which was published in early 2011. We should have searched and reviewed previous literature on this issue more thoroughly.Second, we agree with them that there is 'insufficient' evidence to support the use of pharmacotherapy for smoking cessation in pregnant smokers because no significant efficacy was found in the three placebo-controlled trials, whereas a significant efficacy was found only in the four non placebocontrolled trials. We already described this in the limitations section of the Discussion. We concluded that there 'may' be clinical evidence to support the use of pharmacotherapy for smoking cessation among pregnant smokers.Third, when we reviewed their previous meta-analysis and then compared it with ours, we found that Coleman et al. used a random-effects model in all the analyses, whereas we used both fixed-effects and random-effects models according to the results of the heterogeneity test (i.e. fixed-effects model for data showing less heterogeneity and random-effects model for data showing heterogeneity). Coleman et al. reported the pooled risk ratio (RR) and 95% confidence interval (95% CI) for smoking cessation in later pregnancy after using nicotine replacement therapy (NRT) was 1.63 (0.85-3.14) using a random-effects model. When we performed a 'fixed-effects' meta-analysis using data shown in Figure 2 of Coleman et al.'s review (I 2 = 45%; in our review, when I 2 is <50%, we used a fixed-effects model), NRT was efficacious (pooled RR, 1.47; 95% CI 1.05-2.05; I 2 = 44.9%). Hence, the main reason why the findings and conclusions are not consistent between the two metaanalyses, although similar data were used, is that different models were used, respectively. If Coleman et al. applied a fixed-effects model when I 2 is <50%, their conclusion would also be that NRT is efficacious, as in our review.Last, the remaining issue would be that we should present more conservative findings when the pooled effect sizes are different in the meta-analyses by using between fixed-effects and random-effects models in case of less heterogeneity. We, basically, think that using a fixed-effects model is reasonable although the findings are different between the two models if the heterogeneity test shows less heterogeneity (i.e. I 2 < 50%). However, we want to hear other experts' opinions on this issue. &

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Efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers: a meta‐analysis

Cited by 46 publications

References 25 publications

Are we missing an opportunity to improve smoking cessation rates for pregnant women?

Are we missing an opportunity to improve smoking cessation rates for pregnant women?

Nicotine Replacement Therapy

Authors' response to: Efficacy of nicotine replacement therapy in pregnancy

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