How does nicotine replacement therapy as an adjunct to behavioral support compare with behavioral support alone or with placebo in promoting smoking cessation for pregnant women?

2020 ◽  
Author(s):  
Ashraf Nabhan ◽  
Menna Kamel
Keyword(s):  
Smoking Cessation ◽  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Behavioral Support ◽  
Nicotine Replacement

scholarly journals Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

2020 ◽  
Vol 17 (6) ◽  
pp. 2034 ◽  
Author(s):  
Gillian S. Gould ◽  
Alys Havard ◽  
Ling Li Lim ◽  
Ratika Kumar ◽  
Keyword(s):  
Smoking Cessation ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Systematic Reviews ◽  
Nicotine Replacement ◽  
Increased Risk ◽  
Pertinent Data ◽  
In Pregnancy

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

scholarly journals Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: a systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Parivash Eftekhari ◽  
Michelle Bovill ◽  
Daniel Nigusse Tollosa ◽  
Gillian Sandra Gould
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Meta Analysis ◽  
Grey Literature ◽  
Population Based ◽  
P Value ◽  
Nicotine Replacement

Abstract Background Nicotine replacement therapy (NRT) has proven effect in assisting smoking cessation. However, its effectiveness varies across studies and population groups. This may be due to differences in the rate of adherence. Hence, this review aims to examine the level of adherence to NRT and to assess if the level of adherence to NRT affects success of smoking cessation. Methods A systematic review and meta-analysis was conducted using studies retrieved from five electronic databases (MEDLINE, Scopus, EMBASE, Web of science, and PsycINFO) and grey literature. Pooled analysis was conducted using Stata version 16 software. Methodological quality and risk of bias were assessed using the NIH Quality Assessment Tool. Analyses were done among those studies that used similar measurements to assess level of adherence and successful smoking cessation. Heterogeneity of studies was assessed using the Higgins’ I2 statistical test. Funnel plots and Egger’s regression asymmetry test were used to affirm presence of significant publication bias. Results A total of 7521 adult participants of 18 years old and above from 16 studies were included in the analysis. Level of adherence to NRT among participants of randomised controlled trials were found to be 61% (95% CI, 54–68%), p-value of < 0.001 and I2 = 85.5%. Whereas 26% of participants were adherent among participants of population-based studies with 95% CI, 20–32%, p-value of < 0.001 and I2 = 94.5%. Level of adherence was the lowest among pregnant women (22%) with 95% CI, 18–25%, p-value of 0.31 and I2 = 15.8%. Being adherent to NRT doubles the rate of successful quitting (OR = 2.17, 95% CI, 1.34–3.51), p-value of < 0.001 and I2 = 77.6%. Conclusions This review highlights a low level of adherence to NRT among participants of population-based studies and pregnant women as compared to clinical trials. Moreover, the review illustrated a strong association between adherence and successful smoking cessation. Hence, it is recommended to implement and assess large scale interventions to improve adherence. Health programs and policies are recommended to integrate the issue of adherence to NRT as a core component of smoking cessation interventions. Trial registration PROSPERO registration number: CRD42020176749. Registered on 28 April 2020.

Comparison of a Daily Smartphone App and Retrospective Questionnaire Measures of Adherence to Nicotine Replacement Therapy within Pregnant Women (Preprint)

2021 ◽  
Author(s):  
Joanne Emery ◽  
Yue Huang ◽  
Felix Naughton ◽  
Sue Cooper ◽  
Lisa McDaid ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Face Validity ◽  
Smartphone App ◽  
Nicotine Replacement ◽  
Saliva Cotinine ◽  
Reporting Rates ◽  
Retrospective Questionnaire ◽  
Collection Methods

BACKGROUND Few studies have investigated how to best measure adherence to smoking cessation medications, but continuous usage measures are recommended. OBJECTIVE In this first study of its kind, we compared methods for measuring adherence to nicotine replacement therapy (NRT), investigating the completeness and validity of data collected from daily assessments using a smartphone app versus data collected from retrospective questionnaires. METHODS Women aged ≥16, who were daily smokers <25 weeks pregnant, were offered cessation counselling and encouraged to use NRT. Women set quit dates (QD) and, for 28 days afterwards, were asked to report NRT use daily to a smartphone app and to questionnaires administered in-person or remotely at 7 and 28 days. For both data collection methods, we provided up to £25 in compensation for time taken providing research data. Data completeness and NRT use reported to app and questionnaires were compared. For each method, we also correlated mean daily nicotine doses reported within 7 days of QD with Day 7 saliva cotinine concentrations. RESULTS Of 438 women assessed for eligibility, 40 participated and 35 accepted NRT. More participants (31/35) submitted NRT usage data to the app by Day 28 (median days submitted=25 [IQR 11]) than completed the Day 28 questionnaire (24/35). Data submitted to the app showed a lower reported duration of NRT use compared to the questionnaire (median days NRT for app=24 [IQR 10.25]; questionnaire=28 [4.75], P=.007), and there appeared to be specific cases of overreporting to the questionnaire. Mean daily nicotine doses (mg) between QD and Day 7 were lower when calculated using app data (median mg for app=40 [52.1]; questionnaire=40 [63.1], P=.001), and some large outliers were evident for the questionnaire. Mean daily nicotine doses, adjusted for cigarettes smoked, were not associated with cotinine concentrations for either method (app r=0.184, P=.55; questionnaire r=0.031, P=.92). CONCLUSIONS Daily assessment of NRT use via a smartphone app facilitated more complete data (a higher response rate) than questionnaires, and reporting rates over 28 days were encouraging among pregnant women. Although data from neither method was significantly associated with cotinine concentrations, app data had better face validity; retrospective questionnaires appeared to overestimate NRT use for some.

scholarly journals Efficacy of Vaping as a Nicotine Replacement Therapy for Smoking Cessation Among Adults: A Review of the Literature

2018 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Charl Woo
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Successful Treatment ◽  
Tobacco Cessation ◽  
Nicotine Addiction ◽  
Review Of The Literature ◽  
Nicotine Replacement ◽  
Extreme Hazards ◽  
Cold Turkey

Evidence shows that successful treatment of nicotine addiction improves mortality, despite age at cessation. The extreme hazards of smoking stress the importance of patient-physician discussion that is a significant factor in tobacco cessation. Discussion alone and other methods such as “cold turkey” have proven to have low efficacy at cessation which has led to the development nicotine replacement therapy to help augment cessation.

scholarly journals Audit of inpatient smoking cessation advice

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S92-S93
Author(s):  
Flensham Mohamed ◽  
Mohamed Bader
Keyword(s):  
Smoking Cessation ◽  
Risk Factor ◽  
Physical Health ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Smoking Status ◽  
Health Board ◽  
List Type ◽  
Nicotine Replacement ◽  
Smoking Cessation Advice

AimsAudit carried out to assess whether or not patients had been asked about their smoking status during admission onto an acute adult mental health ward, as well as if they had received any smoking cessation advice or offered nicotine replacement therapy.Background•Physical health outcomes in patients with serious mental illness (SMI) are consisitently worse than the general public This is due to multiple factors; adverse effects of medication (including metabolic syndromes with psychotropics) as well as poor lifestyle factors such as smoking status•Patients with an SMI are 3–6 times more likely to die due to coronary artery disease. 70% of patients in inpatient psychiatric units are smokers, a strong independent risk factor for cardiovascular disease.•Smoking cessation is a potent modifiable risk factor that can prevent mortality and reduce morbidity.MethodA cross-sectional review of all 34 inpatients across four general adult acute psychiatric wards.Patient records were explored using the Aneuran Bevan Health Board admission proformas to identify evidence of smoking status and whether advice was offered.ResultSmoker but not given cessation advice n = 13 (38%)Not asked about smoking n = 11 (32%)Smoker and given cessation advice n = 4 (12%)Non-smoker n = 6 (18%)ConclusionPatients were asked about their smoking status the majority of the time (68%) but provision of advice or nicotine replacement therapy was only done in 14% of potential smokers (identified smokers and patients not asked about smoking status).A consideration to be taken into account is that on admission, a patient's physical health status may be unknown, with the additional difficulty of a patient's acute distress complicating the physical examination, smoking status and modification of patient's smoking status may not be the highest priory in that context.Data regarding asking about smoking were different amongst wards, potentially signifying differences between assessors willingness to ask about smoking status.There is a lack of smoking cessation literature available on the wards and patients are often unaware of what options are available to quit smoking.The audit simply determined whether or not assessors were documenting smoking status, it does not measure the quantity or quality of smoking cessation advice provided.Further quality improvement projects should be launched, with focus groups as the intial step at further investigating inpatient smoking rates, as well as attempting to reduce them in a more systemic way.

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