Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review

AIMS: In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re‐start smoking at time‐points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected...

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Autores principales: Jones, Matthew, Lewis, Sarah, Parrott, Steve, Wormall, Stephen, Coleman, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680353/
https://www.ncbi.nlm.nih.gov/pubmed/26990248
http://dx.doi.org/10.1111/add.13309
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author Jones, Matthew
Lewis, Sarah
Parrott, Steve
Wormall, Stephen
Coleman, Tim
author_facet Jones, Matthew
Lewis, Sarah
Parrott, Steve
Wormall, Stephen
Coleman, Tim
author_sort Jones, Matthew
collection PubMed
description AIMS: In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re‐start smoking at time‐points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected time‐points during the postpartum period (secondary analysis). METHODS: Trials identified from two Cochrane reviews plus searches of Medline and EMBASE. Twenty‐seven trials were included. The included trials were randomized or quasi‐randomized trials of within‐pregnancy cessation interventions given to smokers who reported abstinence both at end of pregnancy and at one or more defined time‐points after birth. Outcomes were validated biochemically and self‐reported continuous abstinence from smoking and 7‐day point prevalence abstinence. The primary random‐effects meta‐analysis used longitudinal data to estimate mean pooled proportions of re‐starting smoking; a secondary analysis used cross‐sectional data to estimate the mean proportions smoking at different postpartum time‐points. Subgroup analyses were performed on biochemically validated abstinence. RESULTS: The pooled mean proportion re‐starting at 6 months postpartum was 43% [95% confidence interval (CI) = 16–72%, I (2) = 96.7%] (11 trials, 571 abstinent women). The pooled mean proportion smoking at the end of pregnancy was 87% (95% CI = 84–90%, I (2) = 93.2%) and 94% (95% CI = 92–96%, I (2) = 88%) at 6 months postpartum (23 trials, 9262 trial participants). Findings were similar when using biochemically validated abstinence. CONCLUSIONS: In clinical trials of smoking cessation interventions during pregnancy only 13% are abstinent at term. Of these, 43% re‐start by 6 months postpartum.
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spelling pubmed-66803532019-08-09 Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review Jones, Matthew Lewis, Sarah Parrott, Steve Wormall, Stephen Coleman, Tim Addiction Reviews AIMS: In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re‐start smoking at time‐points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected time‐points during the postpartum period (secondary analysis). METHODS: Trials identified from two Cochrane reviews plus searches of Medline and EMBASE. Twenty‐seven trials were included. The included trials were randomized or quasi‐randomized trials of within‐pregnancy cessation interventions given to smokers who reported abstinence both at end of pregnancy and at one or more defined time‐points after birth. Outcomes were validated biochemically and self‐reported continuous abstinence from smoking and 7‐day point prevalence abstinence. The primary random‐effects meta‐analysis used longitudinal data to estimate mean pooled proportions of re‐starting smoking; a secondary analysis used cross‐sectional data to estimate the mean proportions smoking at different postpartum time‐points. Subgroup analyses were performed on biochemically validated abstinence. RESULTS: The pooled mean proportion re‐starting at 6 months postpartum was 43% [95% confidence interval (CI) = 16–72%, I (2) = 96.7%] (11 trials, 571 abstinent women). The pooled mean proportion smoking at the end of pregnancy was 87% (95% CI = 84–90%, I (2) = 93.2%) and 94% (95% CI = 92–96%, I (2) = 88%) at 6 months postpartum (23 trials, 9262 trial participants). Findings were similar when using biochemically validated abstinence. CONCLUSIONS: In clinical trials of smoking cessation interventions during pregnancy only 13% are abstinent at term. Of these, 43% re‐start by 6 months postpartum. John Wiley and Sons Inc. 2016-03-16 2016-06 /pmc/articles/PMC6680353/ /pubmed/26990248 http://dx.doi.org/10.1111/add.13309 Text en © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Reviews
Jones, Matthew
Lewis, Sarah
Parrott, Steve
Wormall, Stephen
Coleman, Tim
Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_full Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_fullStr Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_full_unstemmed Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_short Re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
title_sort re‐starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680353/
https://www.ncbi.nlm.nih.gov/pubmed/26990248
http://dx.doi.org/10.1111/add.13309
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