Self help smoking cessation in pregnancy: cluster randomised controlled trial

Area of Science:

• Public Health
• Maternal Health
• Smoking Cessation Research

Background:

• Smoking during pregnancy poses significant risks to both mother and fetus.
• Effective interventions are crucial to improve smoking cessation rates in pregnant women.
• Current self-help approaches may not be sufficient for achieving high cessation rates.

Purpose of the Study:

• To evaluate the effectiveness of a self-help booklet intervention for smoking cessation in pregnant women.
• To assess the impact of the intervention on validated smoking cessation rates and self-reported smoking status.
• To explore the acceptability of the intervention among pregnant women and healthcare providers.

Main Methods:

• A pragmatic cluster randomized controlled trial involving 1527 pregnant smokers across three NHS hospital trusts.
• Intervention group received a series of self-help booklets, with the first booklet delivered by a midwife.
• Primary outcome measured by cotinine validation at the end of the second trimester; secondary outcomes included self-reported smoking and consumption.

Main Results:

• Cotinine-validated smoking cessation rates were low and similar between groups: 18.8% (intervention) vs. 20.7% (usual care).
• Self-reported quit rates were higher but also not significantly different between the intervention and usual care groups.
• The self-help intervention was found to be acceptable to pregnant women and midwives, despite variable delivery.

Conclusions:

• The self-help booklet intervention, delivered during routine antenatal care, was ineffective for smoking cessation in pregnancy.
• Validated smoking cessation rates in this study were lower than self-reported rates, highlighting potential policy implications.
• Future research should focus on developing and evaluating more intensive and tailored interventions for pregnant smokers.