Physical activity for smoking cessation in pregnancy: randomised controlled trial

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Behavioral Medicine

Background:

• Smoking during pregnancy poses significant risks to both maternal and fetal health.
• Behavioral support is a cornerstone of smoking cessation programs for pregnant individuals.
• The role of physical activity as an adjunct to smoking cessation in pregnancy requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of incorporating a physical activity intervention into standard behavioral support for smoking cessation among pregnant women.
• To determine if this combined approach enhances smoking abstinence rates compared to behavioral support alone.

Main Methods:

• A multicenter, randomized controlled trial involving 789 pregnant smokers (10-24 weeks gestation) across 13 hospitals in England.
• Participants were randomized to receive either standard behavioral support for smoking cessation or the same support plus a physical activity intervention (treadmill exercise and consultations).
• The primary outcome was validated continuous smoking abstinence until the end of pregnancy, with secondary measures including physical activity levels and birth outcomes.

Main Results:

• No significant difference in smoking abstinence rates was observed between the physical activity group and the control group (8% vs. 6%).
• The physical activity group reported greater increases in self-reported physical activity, but objective accelerometer data showed no significant difference between groups.
• Adverse events and birth outcomes were similar, with fewer cesarean births in the physical activity group.

Conclusions:

• Integrating a physical activity intervention with behavioral support does not improve smoking cessation rates in pregnant women.
• Physical activity is not recommended as a primary strategy for smoking cessation during pregnancy.
• Physical activity should still be encouraged for its general health benefits in pregnant individuals.