Nicotine replacement therapy and e-cigarettes in pregnancy and infant respiratory outcomes

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

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Randomized, double-blind, placebo-controlled trial of nicotine replacement therapy in pregnancy

Current Therapeutic Research ◽

10.1016/s0011-393x(01)80011-4 ◽

2001 ◽

Vol 62 (4) ◽

pp. 274-278 ◽

Cited By ~ 51

Author(s):

Bhushan Kapur ◽

Richard Hackman ◽

Peter Selby ◽

Julia Klein ◽

Gideon Koren

Keyword(s):

Replacement Therapy ◽

Nicotine Replacement Therapy ◽

Controlled Trial ◽

Double Blind ◽

Nicotine Replacement ◽

Double Blind Placebo ◽

In Pregnancy

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Knowledge and Education as Barriers and Facilitators to Nicotine Replacement Therapy Use for Smoking Cessation in Pregnancy: A Qualitative Study with Health Care Professionals

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101814 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1814 ◽

Cited By ~ 1

Author(s):

Ross Thomson ◽

Lisa McDaid ◽

Joanne Emery ◽

Felix Naughton ◽

Sue Cooper ◽

...

Keyword(s):

Smoking Cessation ◽

Replacement Therapy ◽

Nicotine Replacement Therapy ◽

Health Care Professionals ◽

Educational Interventions ◽

Barriers And Facilitators ◽

Nicotine Replacement ◽

Smoking During Pregnancy ◽

Stop Smoking ◽

In Pregnancy

Smoking during pregnancy is a leading cause of negative pregnancy and perinatal outcomes. While UK guidelines recommend nicotine replacement therapy (NRT) for smoking cessation during pregnancy, adherence to NRT is generally low and may partially explain why NRT appears less effective in pregnancy compared to non-pregnant smokers. This study aimed to identify and describe factors associated with NRT adherence from a health professional’s perspective. Two focus groups and one expert group were conducted with 26 professionals involved in antenatal stop smoking services and the data were analysed thematically using a template methodology. From our analyses, we extracted two main themes: (i) ‘Barriers to NRT use in pregnancy’ explores the issues of how misinformation and unrealistic expectations could discourage NRT use, while (ii) ‘Facilitators to NRT use in pregnancy’ describes the different information, and modes of delivery, that stop smoking professionals believe will encourage correct and sustained NRT use. Understanding the barriers and facilitators to improve NRT adherence may aid the development of educational interventions to encourage NRT use and improve outcomes for pregnant women wanting to stop smoking.

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