The association between treatment adherence to nicotine patches and smoking cessation in pregnancy: A secondary analysis of a randomized controlled trial

Date

2016-10-01

Advisors

Journal Title

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Volume Title

Publisher

Oxford Academic

Type

Article

Peer reviewed

Yes

Abstract

Introduction: In nonpregnant “quitters,” adherence to nicotine replacement therapy (NRT) increases smoking cessation. We investigated relationships between adherence to placebo or NRT patches and cessation in pregnancy, including an assessment of reverse causation and whether any adherence: cessation relationship is moderated when using nicotine or placebo patches. Methods: Using data from 1050 pregnant trial participants, regression models investigated associations between maternal characteristics, adherence and smoking cessation. Results: Adherence during the first month was associated with lower baseline cotinine concentrations (β −0.08, 95% confidence interval [CI] −0.15 to −0.01) and randomization to NRT (β 2.59, 95% CI 1.50 to 3.68). Adherence during both treatment months was associated with being randomized to NRT (β 0.51, 95% CI 0.29 to 0.72) and inversely associated with higher nicotine dependence. Adherence with either NRT or placebo was associated with cessation at 1 month (odds ratio [ OR ] 1.11, 95% CI 1.08 to 1.13) and delivery ( OR 1.06, 95% CI 1.03 to 1.09), but no such association was observed in the subgroup where reverse causation was not possible. Amongst all women, greater adherence to nicotine patches was associated with increased cessation ( OR 2.47, 95% CI 1.32 to 4.63) but greater adherence to placebo was not ( OR 0.98, 95% CI: 0.44 to 2.18). Conclusion: Women who were more adherent to NRT were more likely to achieve abstinence; more nicotine dependent women probably showed lower adherence to NRT because they relapsed to smoking more quickly. The interaction between nicotine-containing patches and adherence for cessation suggests that the association between adherence with nicotine patches and cessation may be partly causal.

Description

Secondary analysis of RCT open access article

Keywords

Citation

Vaz, L.R., Aveyard, P., Cooper, S., Leonardi-Bee, J., Coleman, T., Watts, K. et al (2016) The association between treatment adherence to nicotine patches and smoking cessation in pregnancy: A secondary analysis of a randomized controlled trial. Nicotine and Tobacco Research, 18 (10), pp. 1952-1959

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Research Institute

Institute of Health, Health Policy and Social Care