Interviews fail to reduce smoking in pregnancy
Motivational interviewing does not reduce levels of smoking among pregnant women, a study has found (BMJ 2005;331:373).
The authors warn, however, that, although they found motivational interviewing
to be ineffective, few published trials have demonstrated that nicotine
replacement therapy (NRT) is safe and effective in pregnancy. “Acceptability,
effectiveness and adverse events must be carefully examined before [NRT’s]
widespread use is recommended,” they say.
The trial randomised 762 women to receive either standard health promotion
information or two to five home visits of about 30 minutes’ duration,
in addition to the standard information. The numbers of women in each
group who stopped smoking was not significantly different.
Agnes McGowan, principal health promotion officer at Greater Glasgow
Health Board, is involved with the “breathe” stop smoking
service for pregnant women. She told The Journal: “The breathe
programme has achieved carbon monoxide-validated quit rates of 17 per
cent at week four in a hard-to-reach patient group with complex social
problems using motivational support and NRT.”
The possibility of using NRT is discussed with women who are heavily
addicted. “Treatment with NRT is available for up to 12 weeks and
the first-line treatment is an oral product, although patients who have
previously had problems with an oral NRT product or cannot tolerate an
oral product can be offered 16-hour patches,” she said.
The National Institute for Health and Clinical Excellence is currently
developing guidance on brief interventions for smoking cessation, which
will give particular reference to smoking cessation in pregnancy. The
guidance is expected to be issued in March 2006. |
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