The effect of smoking cessation counselling in pregnant women: a meta-analysis of randomised controlled trials
Article first published online: 22 AUG 2011
© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 12, pages 1422–1428, November 2011
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
- Issue published online: 11 OCT 2011
- Article first published online: 22 AUG 2011
- Accepted 26 May 2011. Published Online 22 August 2011.
- 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.