Historique
Article de Périodique
Effectiveness of smoking cessation interventions among pregnant women: An updated systematic review and meta-analysis (2024)
Auteur(s) :
A. VILA-FARINAS ;
M. PEREZ-RIOS ;
A. MONTES-MARTINEZ ;
A. RUANO-RAVINA ;
A. FORRAY ;
J. REY-BRANDARIZ ;
C. CANDAL-PEDREIRA ;
E. FERNANDEZ ;
B. CASAL-ACCION ;
L. VARELA-LEMA
Article en page(s) :
art. 107854
Sous-type de document :
Méta-analyse / Meta-analysis ; Revue de la littérature / Literature review
Domaine :
Tabac / Tobacco / e-cigarette
Langue(s) :
Anglais
Thésaurus mots-clés
SEXE FEMININ
;
GROSSESSE
;
ARRET DU TABAC
;
INTERVENTION
;
SEVRAGE
;
EFFICACITE
;
METHODE
Résumé :
Objective: To carry out a systematic review of systematic reviews with an update of the existing evidence relating to a broad range of smoking cessation interventions, including psycho-social, digital and pharmacologic interventions, for pregnant women.
Data-sources: Search was conducted in March 2022 in PubMed, EMBASE, and Cochrane in two stages: 1) a search of systematic reviews and meta-analyses, published from January 2012 through January 2022; 2) an update of those that fulfilled eligibility criteria reproducing the primary search strategy.
Study eligibility criteria: We selected randomized clinical trials (RCTs) that evaluated the effectiveness of pharmacological, digital, and psychosocial interventions in aged 18 years and over who were daily smokers, and compared these with routine care, less intense interventions or placebo.
Study appraisal and synthesis methods: Data from eligible studies were manually extracted by two authors and reviewed by a third. The quality of the reviews was evaluated using the AMSTAR scale, and risk of bias was measured with the Rob-2 tool and GRADE level of evidence.
Results: The meta-analysis included 63 RCTs (n = 19849 women). The interventions found to be effective were: financial incentives (RR:1.77; 95%CI:1.21-2.58), counseling (RR:1.27; 95%CI:1.13-1.43) and long-term nicotine replacement therapy (NRT) (RR:1.53; 95%CI:1.16-2.01). Short-term NRT, bupropion, digital interventions, feedback, social support, and exercise showed no effectiveness. The GRADE level of evidence was moderate-to-high for all interventions, with the exception of long-term NRT.
Conclusions: Non-pharmacological interventions for smoking cessation are the most effective for pregnant women. The moderator analysis suggests that pregnant women of low socioeconomic status might benefit less from smoking cessation interventions than women of a high socioeconomic status. These women are usually heavier smokers that live in pro-smoking environments and could require more intensive and targeted interventions.
Highlights:
Multiple smoking-cessation interventions exist and during the past twenty years there has been mounting evidence demonstrating their positive effects in pregnant women.
However, interventions and social societies have evolved, and findings, especially in terms of digital and psychosocial interventions, cannot always be extrapolated over time or across populations.
This work presents an update of the existing evidence on all competing smoking cessation interventions and explores the moderator factors.
Data-sources: Search was conducted in March 2022 in PubMed, EMBASE, and Cochrane in two stages: 1) a search of systematic reviews and meta-analyses, published from January 2012 through January 2022; 2) an update of those that fulfilled eligibility criteria reproducing the primary search strategy.
Study eligibility criteria: We selected randomized clinical trials (RCTs) that evaluated the effectiveness of pharmacological, digital, and psychosocial interventions in aged 18 years and over who were daily smokers, and compared these with routine care, less intense interventions or placebo.
Study appraisal and synthesis methods: Data from eligible studies were manually extracted by two authors and reviewed by a third. The quality of the reviews was evaluated using the AMSTAR scale, and risk of bias was measured with the Rob-2 tool and GRADE level of evidence.
Results: The meta-analysis included 63 RCTs (n = 19849 women). The interventions found to be effective were: financial incentives (RR:1.77; 95%CI:1.21-2.58), counseling (RR:1.27; 95%CI:1.13-1.43) and long-term nicotine replacement therapy (NRT) (RR:1.53; 95%CI:1.16-2.01). Short-term NRT, bupropion, digital interventions, feedback, social support, and exercise showed no effectiveness. The GRADE level of evidence was moderate-to-high for all interventions, with the exception of long-term NRT.
Conclusions: Non-pharmacological interventions for smoking cessation are the most effective for pregnant women. The moderator analysis suggests that pregnant women of low socioeconomic status might benefit less from smoking cessation interventions than women of a high socioeconomic status. These women are usually heavier smokers that live in pro-smoking environments and could require more intensive and targeted interventions.
Highlights:
Multiple smoking-cessation interventions exist and during the past twenty years there has been mounting evidence demonstrating their positive effects in pregnant women.
However, interventions and social societies have evolved, and findings, especially in terms of digital and psychosocial interventions, cannot always be extrapolated over time or across populations.
This work presents an update of the existing evidence on all competing smoking cessation interventions and explores the moderator factors.
Affiliation :
Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruna, Spain
Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruna, Spain
Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain