Adherence to nicotine replacement therapy among pregnant smokers.
BACKGROUND
This secondary analysis examined the association between adherence to nicotine replacement therapy (NRT) and smoking cessation among pregnant smokers enrolled in Baby Steps, an open-label randomized controlled trial testing cognitive-behavioral therapy (CBT) versus CBT plus NRT.


METHODS
The analysis included only women who received NRT for whom we had complete data (N = 104). Data came from daily calendars created from recordings of counseling sessions and from telephone surveys at baseline and 38 weeks gestation.


RESULTS
Overall, 29% of the 104 women used NRT for the recommended 6 weeks and 41% used NRT as directed in the first 48 hr after a quit attempt. Ordinal logistic regression modeling indicated that using NRT as directed in the first 48 hr and having made a previous quit attempt were the strongest predictors of longer NRT use. Univariate analyses suggested that primigravid women and women who used NRT longer were more likely to report quitting at 38 weeks gestation.


CONCLUSIONS
Findings indicated that adherence to NRT is low among pregnant smokers, but adherence was a predictor of cessation. Future trials should emphasize adherence, particularly more days on NRT, to promote cessation during pregnancy.
Department of Community and Family Medicine, Duke University Medical Center and Cancer Prevention, Detection, and Control Research Program, Duke Comprehensive Cancer Center, 2424 Erwin Road, Suite 602, Durham, NC 27705, USA. fish0006@mc.duke.edu
Laura J
LJ
Fish
Bercedis L
BL
Peterson
Rebecca J
RJ
Namenek Brouwer
Pauline
P
Lyna
Cheryl A
CA
Oncken
Geeta K
GK
Swamy
Evan R
ER
Myers
Pamela K
PK
Pletsch
Kathryn I
KI
Pollak
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use*; D010349:Patient Compliance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D009538:Nicotine