Efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers: a meta-analysis.
BACKGROUND
The efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers has not yet been established.


OBJECTIVE
To investigate the efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers.


METHODS
A search was made of PubMed, Embase and CENTRAL in June 2011.


METHODS
Randomised controlled trials (RCTs), quasi-RCTs and retrospective or prospective controlled studies were included.


METHODS
The main analyses were designed to examine the efficacy of pharmacotherapy for smoking cessation among pregnant smokers based on the longest follow-up data available and from data obtained at the latest available time-point in pregnancy in each study.


RESULTS
Of 74 articles identified from the databases, seven studies (five RCTs, one quasi-RCT and one prospective study) involving a total of 1386 pregnant smokers, 732 in the intervention groups and 654 in the control groups, were included in the final analyses. In a fixed-effects meta-analysis of all seven studies based on the longest follow-up data available, pharmacotherapy had a significant effect on smoking cessation (relative risk [RR] 1.80; 95% confidence interval [CI] 1.32-2.44). Subgroup meta-analysis by type of study design also showed similar findings for RCTs (RR 1.48; 95% CI 1.04-2.09) and other types of studies (RR 3.25; 95% CI 1.65-6.39). The abstinence rate at late pregnancy in the intervention ranged from 7 to 22.6% (mean abstinence rate 13.0%; 95% CI 10.9-15.2%). A few minor adverse effects and serious adverse effects were reported in several studies.


CONCLUSIONS
This study indicates that there may be clinical evidence to support the use of pharmacotherapy for smoking cessation among pregnant smokers. Further RCTs are needed.
Smoking Cessation Clinic, Family Medicine Clinic, and Centre for Cancer Prevention and Detection, National Cancer Centre, Gyeonggi-do, South Korea. msk@ncc.re.kr
S-K
SK
Myung
W
W
Ju
H-S
HS
Jung
C-H
CH
Park
S-W
SW
Oh
Hg
H
Seo
Hs
H
Kim
D000328:Adult; D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D018849:Controlled Clinical Trials as Topic; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011810:Quinoxalines / Q000627:therapeutic use; D016540:Smoking Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices; D000068580:Varenicline; D055815:Young Adult
D001552:Benzazepines; D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D000068580:Varenicline