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Background: Smoking during their pregnancy or even through a portion of the pregnancy put the unborn child at risk for many complications during pregnancy and after delivery. Teaching smoking cessation is vital to women of childbearing age. Smoking cessation provides immediate and long-term benefits for pregnant women and their children. Purpose:The purpose of this study is to describe the degree of variability in the methodological approaches and theoretical frameworks of behavioral intervention for smoking cessation during pregnancy. Methods:The design selected for this research is integrative review. Twenty-four articles were reviewed. The inclusion criteria were: (a) studies published between 2000 and 2013, (b) studies published in the English language, (c) a smoking cessation intervention program that targeted pregnant women, and (d) measurement of smoking status after a smoking cessation intervention was implemented. A data extraction tool developed for the purpose of this study utilizing the frameworks of Cooper (1984), and Stetler and colleagues (1998).Results: Seventy percent of the reviewed studies reported either smoking cessation or a reduction in smoking as a result of participating in a smoking cessation program. The reviewed studies confirmed that smoking cessation interventions should begin at the beginning of pregnancy, as early pregnancy is a peak opportunity for education. It is highly beneficial if the interventions last throughout the woman's pregnancy to ensure smoking cessation through the duration of the post-partum period. Conclusion:The majority of the reviewed interventions proved to be highly beneficial with the reduction in smoking or smoking cessation. Additional research is needed to evaluate individual treatment modalities using a side-by-side comparison.
Background: Smoking during their pregnancy or even through a portion of the pregnancy put the unborn child at risk for many complications during pregnancy and after delivery. Teaching smoking cessation is vital to women of childbearing age. Smoking cessation provides immediate and long-term benefits for pregnant women and their children. Purpose:The purpose of this study is to describe the degree of variability in the methodological approaches and theoretical frameworks of behavioral intervention for smoking cessation during pregnancy. Methods:The design selected for this research is integrative review. Twenty-four articles were reviewed. The inclusion criteria were: (a) studies published between 2000 and 2013, (b) studies published in the English language, (c) a smoking cessation intervention program that targeted pregnant women, and (d) measurement of smoking status after a smoking cessation intervention was implemented. A data extraction tool developed for the purpose of this study utilizing the frameworks of Cooper (1984), and Stetler and colleagues (1998).Results: Seventy percent of the reviewed studies reported either smoking cessation or a reduction in smoking as a result of participating in a smoking cessation program. The reviewed studies confirmed that smoking cessation interventions should begin at the beginning of pregnancy, as early pregnancy is a peak opportunity for education. It is highly beneficial if the interventions last throughout the woman's pregnancy to ensure smoking cessation through the duration of the post-partum period. Conclusion:The majority of the reviewed interventions proved to be highly beneficial with the reduction in smoking or smoking cessation. Additional research is needed to evaluate individual treatment modalities using a side-by-side comparison.
Background Tobacco smoking in pregnancy remains one of the few preventable factors associated with complications in pregnancy, stillbirth, low birthweight and preterm birth and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and increasing in low- to middle-income countries. Objectives To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. Search methods In this fifth update, we searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (1 March 2013), checked reference lists of retrieved studies and contacted trial authors to locate additional unpublished data. Selection criteria Randomised controlled trials, cluster-randomised trials, randomised cross-over trials, and quasi-randomised controlled trials (with allocation by maternal birth date or hospital record number) of psychosocial smoking cessation interventions during pregnancy. Data collection and analysis Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, and subgroup analyses and sensitivity analysis were conducted in SPSS. Main results Eighty-six trials were included in this updated review, with 77 trials (involving over 29,000 women) providing data on smoking abstinence in late pregnancy. In separate comparisons, counselling interventions demonstrated a significant effect compared with usual care (27 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.75), and a borderline effect compared with less intensive interventions (16 studies; average RR 1.35, 95% CI 1.00 to 1.82). However, a significant effect was only seen in subsets where counselling was provided in conjunction with other strategies. It was unclear whether any type of counselling strategy is more effective than others (one study; RR 1.15, 95% CI 0.86 to 1.53). In studies comparing counselling and usual care (the largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy (eight studies; average RR 1.06, 95% CI 0.93 to 1.21). However, a clear effect was seen in smoking abstinence at zero to five months postpartum (10 studies; average RR 1.76, 95% CI 1.05 to 2.95), a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77), and a significant effect at 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), but not in the longer term. In other comparisons, the effect was not significantly different from the null effect for most secondary outcomes, but sample sizes were small. Incentive-based interventions had the largest effect size compared with a less intensive intervention (one study; RR 3.64, 95% CI 1.84 to 7.23) and an alternative intervention (one study; RR 4.05, 95% CI 1.48 to 11.11). Feedback interventions demonstrated a significa...
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