From the Guidelines
Behavioral interventions are the most effective method for smoking cessation in pregnancy without using pharmacological interventions.
Key Components of Behavioral Interventions
- Counseling: Behavioral counseling, including feedback, health education, incentives, and social support, has been shown to be effective in improving rates of smoking cessation and perinatal health outcomes in pregnant women 1.
- Intensity and Duration: More intensive counseling, with at least 91 minutes of total contact time, and multiple sessions (≥4) tend to be more successful in achieving smoking cessation 1.
- Tailored Messages: Counseling sessions augmented with messages and self-help materials tailored for pregnant women who smoke can increase abstinence rates during pregnancy 1.
- Clear Advice: Counseling should include clear, strong advice to quit as soon as possible, and messages about the effects of smoking on both maternal and fetal health 1.
Benefits of Behavioral Interventions
- Increased Abstinence Rates: Behavioral interventions can increase rates of smoking abstinence from approximately 11% to 15% in pregnant women 1.
- Improved Perinatal Health Outcomes: Behavioral interventions have been shown to improve mean birthweight, rates of low birthweight, and rates of preterm birth in infants of pregnant women who smoke 1.
From the Research
Smoking Cessation Methods in Pregnancy
The most effective method for smoking cessation in pregnancy without using pharmacological interventions is a topic of interest in several studies 2, 3, 4, 5.
Non-Pharmacological Interventions
- Counseling and pregnancy-specific materials are effective cessation aids for many pregnant women 2.
- A short counseling session with pregnancy-specific educational materials and a referral to the smokers' quit line is an effective smoking cessation strategy 4, 5.
- The 5A's is an office-based intervention developed to be used under the guidance of trained practitioners to help pregnant women quit smoking 4, 5.
- Interventions including education, counselling, self-help, and financial incentives delivered by GPs, midwives, counsellors, and pregnancy advisers have shown to be effective in increasing smoking cessation rates 3.
Effectiveness of Interventions
- Primary care is a suitable area to provide smoking cessation interventions, as it is often the first point of care and more easily accessible than secondary care 3.
- An increase in smoking cessation rates was seen in intervention and control groups, demonstrating the effectiveness of these interventions 3.
- Approximately 54% of women who smoke before pregnancy quit smoking directly before or during pregnancy, and smoking cessation at any point in gestation benefits the pregnant woman and her fetus 2.
Importance of Smoking Cessation in Pregnancy
- Smoking during pregnancy is associated with maternal, fetal, and infant morbidity and mortality 4, 5.
- Children born to women who smoke during pregnancy are at an increased risk of respiratory infections, asthma, infantile colic, bone fractures, and childhood obesity 2.
- The greatest benefit of smoking cessation is observed with cessation before 15 weeks of gestation 2.