What factors influence uptake and subsequent use of nicotine replacement therapy (NRT) and e-cigarettes in pregnant women who smoke?

2020 ◽  
Author(s):  
Jane Burch ◽  
Juliana Ester Martin
Keyword(s):  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Nicotine Replacement

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 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.

scholarly journals Perceptions of emerging tobacco products and nicotine replacement therapy among pregnant women and women planning a pregnancy

2016 ◽  
Vol 4 ◽  
pp. 481-485 ◽  
Author(s):  
Lucinda J. England ◽  
Van T. Tong ◽  
Amber Koblitz ◽  
Julia Kish-Doto ◽  
Molly M. Lynch ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Tobacco Products ◽  
Nicotine Replacement

scholarly journals Comparison of Cotinine Levels in Pregnant Women While Smoking and When Using Nicotine Replacement Therapy

2014 ◽  
Vol 16 (6) ◽  
pp. 895-898 ◽  
Author(s):  
Katharine A. Bowker ◽  
Sarah Lewis ◽  
Tim Coleman ◽  
Luis R. Vaz ◽  
Sue Cooper
Keyword(s):  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Nicotine Replacement
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