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The effect of smoking cessation counselling in pregnant women: a meta-analysis of randomised controlled trials

  1. KB Filion1,
  2. HA Abenhaim2,
  3. S Mottillo3,4,
  4. L Joseph5,6,
  5. A Gervais7,
  6. J O’Loughlin8,
  7. G Paradis5,
  8. R Pihl9,
  9. L Pilote5,6,10,
  10. S Rinfret11,
  11. M Tremblay12,
  12. MJ Eisenberg3,5

Article first published online: 22 AUG 2011

DOI: 10.1111/j.1471-0528.2011.03065.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 118, Issue 12, pages 1422–1428, November 2011

Additional Information

How to Cite

Filion, K., Abenhaim, H., Mottillo, S., Joseph, L., Gervais, A., O’Loughlin, J., Paradis, G., Pihl, R., Pilote, L., Rinfret, S., Tremblay, M. and Eisenberg, M. (2011), The effect of smoking cessation counselling in pregnant women: a meta-analysis of randomised controlled trials. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 1422–1428. doi: 10.1111/j.1471-0528.2011.03065.x

Author Information

  1. 1

    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

  2. 2

    Department of Obstetrics and Gynecology

  3. 3

    Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital

  4. 4

    Faculty of Medicine, University of Montreal

  5. 5

    Department of Epidemiology, Biostatistics and Occupational Health, McGill University

  6. 6

    Division of Clinical Epidemiology, McGill University Health Center

  7. 7

    Agence de la santé et des services sociaux, Direction de santé publique

  8. 8

    Centre de Recherche du Centre Hospitalier de l’Université de Montréal and Department of Social and Preventive Medicine, University of Montreal

  9. 9

    Department of Psychology, McGill University

  10. 10

    Division of Internal Medicine, McGill University Health Center, Montreal

  11. 11

    Clinical and Interventional Cardiology, Multidisciplinary Cardiology Department, Laval Hospital, Quebec Heart and Lung Institute, Sainte-Foy

  12. 12

    Développement des individus et des communautés, Institut national de santé publique, Montreal, QC, Canada

*MJ Eisenberg, Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, 3755 Côte Ste-Catherine Road, Suite H-421, Montreal, QC H3T 1E2, Canada. Email mark.eisenberg@mcgill.ca

Publication History

  1. Issue published online: 11 OCT 2011
  2. Article first published online: 22 AUG 2011
  3. Accepted 26 May 2011. Published Online 22 August 2011.

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Keywords:

  • Counselling;
  • meta-analysis;
  • pregnancy;
  • smoking cessation

Please cite this paper as: Filion K, Abenhaim H, Mottillo S, Joseph L, Gervais A, O’Loughlin J, Paradis G, Pihl R, Pilote L, Rinfret S, Tremblay M, Eisenberg M. The effect of smoking cessation counselling in pregnant women: a meta-analysis of randomised controlled trials. BJOG 2011;118:1422–1428.

Background  Pregnant smokers are often prescribed counselling as part of multicomponent cessation interventions. However, the isolated effect of counselling in this population remains unclear, and individual randomised controlled trials (RCTs) are inconclusive.

Objective  To conduct a meta-analysis of RCTs examining counselling in pregnant smokers.

Search strategy  We searched the CDC Tobacco Information and Prevention, Cochrane Library, EMBASE, Medline and PsycINFO databases for RCTs evaluating smoking cessation counselling.

Selection criteria  We included RCTs conducted in pregnant women in which the effect of counselling could be isolated and those that reported biochemically validated abstinence at 6 or 12 months after the target quit date.

Data collection and analysis  Overall estimates were derived using random effects meta-analysis models.

Main results  Our search identified eight RCTs (n = 3290 women), all of which examined abstinence at 6 months. The proportion of women that remained abstinent at the end of follow up was modest, ranging from 4 to 24% among those randomised to counselling and from 2 to 21% among control women. The absolute difference in abstinence reached a maximum of only 4%. Summary estimates are inconclusive because of wide confidence intervals, albeit with little evidence to suggest that counselling is efficacious at promoting abstinence (odds ratio 1.08, 95% confidence interval 0.84–1.40). There was no evidence to suggest that efficacy differed by counselling type.

Conclusions  Available data from RCTs examining the isolated effect of smoking cessation counselling in pregnant women are limited but sufficient to rule out large treatment effects. Future RCTs should examine pharmacological therapies in this population.

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