title: The effect of smoking cessation counselling in pregnant women: a meta-analysis of randomised controlled trials.
abstract: 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.
  
  
  METHODS
  We searched the CDC Tobacco Information and Prevention, Cochrane Library, EMBASE, Medline and PsycINFO databases for RCTs evaluating smoking cessation counselling.
  
  
  METHODS
  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.
  
  
  METHODS
  Overall estimates were derived using random effects meta-analysis models.
  
  
  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.
authors: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA.
authors: K B
authors: KB
authors: Filion
authors: H A
authors: HA
authors: Abenhaim
authors: S
authors: S
authors: Mottillo
authors: L
authors: L
authors: Joseph
authors: A
authors: A
authors: Gervais
authors: J
authors: J
authors: O'Loughlin
authors: G
authors: G
authors: Paradis
authors: R
authors: R
authors: Pihl
authors: L
authors: L
authors: Pilote
authors: S
authors: S
authors: Rinfret
authors: M
authors: M
authors: Tremblay
authors: M J
authors: MJ
authors: Eisenberg
mesh_terms: D037001:Directive Counseling; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data