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Clinical effects of pharmacological and electronic cigarette interventions for smoking cessation in pregnancy: a
Phiyanuch Thimkorn1, Chimbun Booncharoen2, Panitnan Chaipitak2
1The Research Unit of Evidence Synthesis (TRUES), Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Abhaibhubejhr Collage of Thai Traditional Medicine, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Ministry of Public Health, Prachinburi, Thailand; Advancing Collaboration, Translation, and Innovation for Value in Evidence Synthesis (ACTIVES) Hub of Talent, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
Background:
Smoking during pregnancy adversely affects both mothers and fetuses. This study aimed to evaluate the clinical effects of pharmacological and electronic cigarette (E-cigarette) interventions in supporting smoking cessation among pregnant women.
Methods:
PubMed, EMBASE, CENTRAL, and EBSCO Open Dissertations were searched from inception to December 2024. Randomized controlled trials (RCTs) assessing pharmacotherapies or E-cigarette for smoking cessation during pregnancy were included. Quality of included RCTs was evaluated using the Cochrane risk of bias tool for randomized trials (RoB2). Pooled effects were measured using a random-effects model. The surface under the cumulative ranking curve (SUCRA) were used to rank intervention effects.
Results:
Of 1,720 articles, 11 RCTs (n = 4,065) were included. One trial had a low risk of bias, three had some concerns, and six had a high risk. Both the combined use of nicotine patch and gum (relative risk [RR] 3.22; 95% confidence interval [CI]: 1.40, 7.39) and E-cigarette (RR 1.81; 95%CI: 1.11, 2.93) significantly improved point prevalence abstinence compared to usual care, with SUCRA values of 97.0% and 81.3%, respectively. Nicotine gum was significantly associated with higher birthweight (mean difference [MD] 337.00; 95% CI: 103.18, 570.82) and a lower risk of preterm birth compared to usual care (RR 0.39; 95% CI: 0.17, 0.91).
Conclusions:
The combination of a nicotine patch and gum and E-cigarette use are effective for smoking cessation in pregnant women. However, these findings were based on a limited number of studies, and further high-quality randomized controlled trials are needed to confirm their effectiveness.
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