Association of nicotine replacement therapy use in pregnancy and smoking cessation in clinical practice
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Click here to download the presentation (Powerpoint or viewer needed) | Author(s)
Leonie S. Brose, Andy McEwen and Robert West
| | Presenter(s) |
Leonie Brose Research Associate, National Centre for Smoking Cessation (NCSCT) and Training & University College London | Abstract Background: There is an urgent need to find ways of helping pregnant smokers to stop. Randomized controlled trials (RCTs) have not detected an effect of nicotine replacement therapy (NRT) for smoking cessation in pregnancy. This may be because of inadequate dosing because of faster nicotine metabolism in pregnancy. We examined whether combination NRT (patch plus a faster acting form) is associated with higher quit rates.
Methods: Data from 3,880 pregnant clients trying to stop with the support of one of 44 Stop Smoking Services. CO-verified 4-week abstinence rates were compared between those not using medication versus single NRT and combination NRT, taking into account intervention setting (specialist clinic, home visit, primary care, other), intervention type (one-to-one, group, drop-in, other), months pregnant, age, ethnic group and occupational group.
Results: Combination NRT was associated with higher odds of quitting compared with no medication (OR=1.93, 95% CI=1.13 to 3.29, p=0.016), whereas single NRT showed no significant benefit (OR=1.06, 95% CI=0.60 to 1.86, p=0.838).
Conclusions: Use of combination NRT appears to confer a benefit in terms of promoting smoking cessation during pregnancy. While this conclusion is based on correlational data, it lends support to continuing this treatment option pending confirmation by an RCT.
| Source of funding: Cancer Research UK and NCSCT.
| Declaration of interest: Robert West undertakes research and consultancy and receives fees for speaking from companies that develop and manufacture smoking cessation medications (Pfizer, J&J, McNeil, GSK, Nabi, Novartis, and Sanofi-Aventis). He also has a share of a patent for a novel nicotine delivery device. Andy McEwen undertakes research and consultancy and receives fees for speaking from companies that develop and manufacture smoking cessation medications (Pfizer, GSK and Novartis). He also has a share of a patent for a novel nicotine delivery device and he is the director of the National Centre for Smoking Cessation and Training (NCSCT).
Leonie Brose's post is funded by the NCSCT.
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