Helping pregnant smokers quit: meeting the challenge in the next decade

Ct, Orleans; Dc, Barker; Nj, Kaufman; Jf, Marx

doi:10.1136/tc.9.suppl_3.iii6

Cited by 62 publications

(25 citation statements)

References 33 publications

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“…1 Although fewer women in the US and Britain now smoke than in past decades, an increasing number of teenage girls are initiating smoking, and smoking rates are declining less rapidly among women than among men, so cigarette smoking remains common among women who are of childbearing age, pregnant, or breastfeeding. [1][2][3][4] In the developing world, a small but rapidly expanding proportion of women smoke. 5 Exposure to cigarette smoke in utero puts a fetus at increased risk for a number of adverse health outcomes, including growth restriction.…”

Section: Introductionmentioning

confidence: 99%

“…5 Exposure to cigarette smoke in utero puts a fetus at increased risk for a number of adverse health outcomes, including growth restriction. 2,6 Whereas smaller size at birth is generally associated with reduced later risk for overweight, 7 recent research suggests that mothers who smoke during pregnancy have children at increased risk for later obesity. The combination of small size at birth and overweight in later life is not only characteristic of the epidemiologic transition from acute to chronic disease, but also confers a high risk of cardiovascular outcomes in adulthood.…”

Section: Introductionmentioning

confidence: 99%

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Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

2007

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Objective: Perform a systematic review of studies reporting on the association between maternal prenatal cigarette smoking and child overweight. Design: Meta-analysis of observational studies. Data sources: Medline search and review of reference lists among studies published through June 2006. Review methods: Included studies reported an association between maternal smoking during pregnancy and risk of overweight among children at least 2 years of age. We did not include in the meta-analysis studies that provided only a continuous measure of adiposity, although those studies are discussed separately. Results: Based on results of 84 563 children reported in 14 observational studies, children whose mothers smoked during pregnancy were at elevated risk for overweight (pooled adjusted odds ratio (OR) 1.50, 95% CI: 1.36, 1.65) at ages 3-33 years, compared with children whose mothers did not smoke during pregnancy. The pooled estimate from unadjusted odds ratios (OR 1.52, 95% CI: 1.36, 1.69) was similar to the adjusted estimate, suggesting that sociodemographic and behavioral differences between smokers and nonsmokers did not explain the observed association. Although we observed evidence for publication bias, simulating a symmetric set of studies yielded a similar estimate (OR 1.40, 95% CI: 1.26, 1.55). Conclusions:Prenatal smoking exposure appears to increase rates of overweight in childhood. In parts of the world undergoing the epidemiologic transition, the continuing increase in smoking among young women could contribute to spiraling increases in rates of obesity-related health outcomes in the 21st century.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

2007

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“…The direct medical costs of a complicated birth for a smoker are 66% higher than for nonsmokers. 1 Relapse rates range from 70% to 85% among women who smoke but quit at some time during their pregnancy. A recent 10-year study (1987 to 1996) of 8808 pregnant women and 178,499 nonpregnant women of childbearing age indicated that the prevalence of current smoking has decreased significantly among both pregnant (16.3% to 11.8%) and nonpregnant women (26.7% to 23.6%).…”

mentioning

confidence: 99%

Smoking Cessation in Pregnancy: A Review of Postpartum Relapse Prevention Strategies

Fang¹,

Goldstein

Butzen³

et al. 2004

The Journal of the American Board of Family Medicine

114

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Objective: Review and examine existing research, current strategies, and directions for future research on smoking cessation relapse and relapse prevention in pregnancy and postpartum.Methods: A MEDLINE/PubMed search in 2002 and 2003 for articles containing the key words "smoking," "pregnancy," "cessation," and "cessation relapse prevention" and references of retrieved papers yielded a review of more than 500 articles. Only 14 of these addressed program-based strategies to increase cessation among pregnant women through relapse prevention programs.Conclusion: Although there is much information on the rationale and strategies for smoking cessation for pregnant women, fewer studies exist on how to prevent relapse. Throughout the past decade, tobacco use has remained the single most important modifiable cause of poor pregnancy outcome in the United States. Smoking accounts for 20% of deliveries of infants with low birth weights, 8% of preterm births, and 5% of all perinatal deaths. Smoking during pregnancy and in postpartum contributes to sudden infant death syndrome and changes in brain and nervous system development. The direct medical costs of a complicated birth for a smoker are 66% higher than for nonsmokers. 1 Relapse rates range from 70% to 85% among women who smoke but quit at some time during their pregnancy. A recent 10-year study (1987 to 1996) of 8808 pregnant women and 178,499 nonpregnant women of childbearing age indicated that the prevalence of current smoking has decreased significantly among both pregnant (16.3% to 11.8%) and nonpregnant women (26.7% to 23.6%).2 This drop in smoking over time among pregnant women was primarily caused by the overall decline in smoking initiation rates among women of childbearing age, not by an increased rate of smoking cessation related to pregnancy.Although one fifth of pregnant smokers spontaneously quit by the time of their first antenatal visit, 3 and pregnant women are half as likely as nonpregnant women to be smokers, 2 an estimated 20.4% of women smokers continue smoking throughout their pregnancies. 4 For women who do quit during pregnancy and who received a planned intervention, between 6.2% and 37.2% remained smoke-free. The range of relapse rates is broad because of the varying success of the cessation intervention strategy. Between 29% and 85% of women who get a planned intervention relapse after delivery. 5-16Although there is much information on why and how pregnant women should quit, fewer data exist on how to prevent relapse. This article is a literature review on relapse and relapse prevention in pregnancy; we looked at existing research, current strategies, and directions for future research.

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“…In a Cochrane literature review, interventions with high intensity and high quality yielded the greatest cessation rates in late pregnancy [21] and the lower intensity treatments increased abstinence rates compared with usual care [22,23]. In addition, even the most effective interventions seldom exceeded cessation rates of 20% among maternal smoking women [16]. Therefore, these interventions should be linked to design issues during early stages of intervention development [24].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, interventions should be developed to address the key factors to motivate maternal smoking women in quitting smoking [16] and to help smoking women in behaviour change approach [17]. In that direction, Becker [18] presented the health belief model, Maddux and Rogers [19] presented protection motivation theory and the theory of reasoned action was proposed by Fishbein and Azjen [20].…”

Section: Introductionmentioning

confidence: 99%

Application of causal model to maternal smoking cessation intervention in pregnancy

Ansari¹,

Dixon²,

Browning³

et al. 2013

OJPM

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The adverse effects of maternal smoking during pregnancy on both the offspring and women are well known. The main objective of this research article is to provide health professional causal modelling approach to make a more comprehensive assessment of major determinants of smoking behaviour during and after pregnancy and consequently the outcomes of pregnant women smoking which are adversely affecting both the offspring and pregnant women. The causal model based on theory and evidence was modified and applied to material smoking cessation intervention to control the adverse effects of smoking on offspring obesity and neurodevelopment. In this approach a generic model links behavioural determinants, causally through behaviour, to physiological and biochemical variables, and health outcomes. It is tailored to context, target population, behaviours and health outcomes. The model provides a rational guide to appropriate measures, intervention points and intervention techniques, and can be tested quantitatively. The causal modelling approach showed promising results which can be used to help maternal smoking women to understand the risk of smoking and help them to quit smoking. The regression analysis of maternal smoking women BMI (n = 1000) on offspring BMI was statistically significant, p < 0.05, 95% CI (0.28 -0.38) and so was the analysis of offspring SBP on maternal BMI for male offsprings, p < 0.05, 95% CI (0.06 -0.43) but not for female offsprings (p > 0.05). This supported the hypothesis that maternal smoking women BMI during pregnancy is an important determinant of offspring obesity and consequently the risk factors of cardiovascular development. The causal modelling approach is unique as it provides an incentive to health professional to use these models to target any important and modifiable determinants of the maternal smoking behaviour and decrease the risk of adverse pregnancy outcomes for the offspring and the mother.

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Helping pregnant smokers quit: meeting the challenge in the next decade

Cited by 62 publications

References 33 publications

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

Smoking Cessation in Pregnancy: A Review of Postpartum Relapse Prevention Strategies

Application of causal model to maternal smoking cessation intervention in pregnancy

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