| Summary: | Introduction
Smoking cessation during pregnancy is beneficial to both
the mother and child. Our objective was to assess if an intensive smoking
cessation intervention for pregnant women increases: a) rates of smoking
cessation, and b) reduces exposure to tobacco-specific carcinogens during
pregnancy.
Methods
A two-group single-blinded parallel randomized controlled trial
(RCT) was conducted involving 84 pregnant smokers in either a high intensity
(n=42) or minimal contact control group (n=42). Women assigned to the high
intensity smoking cessation intervention group received a single 30-minute
behavioural counselling session and a tailored self-help booklet. The primary
outcome measures were: 7-day point prevalence abstinence measured by selfreport
and urine cotinine levels, and maternal tobacco specific carcinogens
nitrosamine (NNAL) urine concentrations assessed at 32 weeks of gestation.
Results
A significantly greater percentage of pregnant smokers quit smoking
in the high intensity group compared to the low intensity control group (45.2%
vs 21.4%; p=0.001). A significant decrease in urine cotinine concentrations was
documented in the experimental group (-140.74 ± 361.70 ng/mL; p=0.004),
with no significant decrease documented in the control group. A significant
decrease in NNAL levels was also documented in the experimental group
(158.17 ± 145.03 pg/mL before, 86.43 ± 112.54 pg/mL after; p=0.032) with
no significant changes in the control group.
Conclusions
The high intensity intervention tested resulted in significantly
greater cessation rates. Intensive smoking cessation interventions can be
effective in reducing fetal exposure to NNAL. This is the first trial to report
on NNAL tobacco-specific carcinogen concentrations before and after an
intervention for smoking cessation during pregnancy.
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