Psychological interventions for smoking cessation in pregnant women:A systematic review

Smoking during pregnancy poses significant risks to maternal and neonatal health. Nonetheless, a high proportion of women continue to smoke during this period, and effective interventions are thus needed to help pregnant women quit smoking. The aim of this review was to determine which psychological interventions for smoking cessation in pregnancy have been implemented and the efficacy rates of each.

Thirty-five studies analysing the efficacy of a psychological smoking cessation intervention, published between January 2010 and December 2024, were identified in PsycINFO, PubMed and Web of Science databases and included in this review.

Interventions were categorised as face-to-face (n = 17) and non-face-to-face (n = 18). Face-to-face interventions included brief interventions (n = 10), cognitive-behavioural interventions (n = 5) and interventions to enhance support (n = 2). Non-face-to-face interventions were delivered via text message (n = 10), a web-based system (n = 1), mobile app (n = 2) and phone calls (n = 5). The abstinence rates were between 8.4% and 51% for brief interventions and between 9.6% and 37.3% for cognitive-behavioural interventions. Only two of the non-face-to-face interventions were effective for smoking cessation, with abstinence rates of 57% at delivery for a mobile app and 14.4% abstinence at 6 months postpartum for a telephone intervention.

Of the face-to-face interventions, brief interventions and cognitive-behavioural interventions are the most commonly used and effective option for smoking cessation in pregnancy. The most promising non-face-to-face interventions are interventions via mobile apps or phone calls, whilst further studies are required.

This review reveals the state of research on smoking cessation psychological interventions in pregnancy in the last 15 years. It describes the most effective psychological treatment options, based on the mode of delivery (face-to-face and non-face-to-face). It also identifies the characteristics of the interventions in terms of the timing of their implementation, as well as the number, duration, and content of the sessions, offering guidelines for clinical practice necessary to implement future interventions to help women quit smoking during pregnancy.