Nicotine replacement therapy and other interventions for pregnant smokers: Pregnancy Risk Assessment Monitoring System, 2009–2010

• Published in: Preventive medicine Vol. 78; pp. 92 - 100
• Main Authors: Kapaya, Martha, Tong, Van, Ding, Helen
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2015
• Subjects: Adult; Female; Humans; Internal Medicine; Maternal Behavior - psychology; Maternal smoking; Nicotine - administration & dosage; Nicotine replacement therapy; Nicotinic Agonists - administration & dosage; Pregnancy; Pregnancy Complications - prevention & control; Prenatal Care - methods; Prenatal care counseling; Risk Assessment; Smoking; Smoking cessation; Smoking Cessation - methods; Tobacco use cessation products; Tobacco Use Cessation Products - utilization; United States; Young Adult; United States; Smoking cessation; Tobacco use cessation products; Prenatal care counseling; Nicotine replacement therapy; Smoking; Maternal smoking
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2015.07.008

Abstract Background Current U.S. guidelines recommend consideration of nicotine replacement therapy (NRT) for pregnant smokers if behavioral therapies fail, only under close supervision of a provider, and after discussion of known risks of continued smoking and possible risks of NRT. The percentage of pregnant smokers offered NRT by their prenatal care providers is unknown. Purpose The study aims to calculate the percentage of pregnant smokers offered cessation intervention and NRT and assess independent associations between selected maternal characteristics and being offered NRT. Methods Data were analyzed from the 2009–2010 Pregnancy Risk Assessment Monitoring System from four states that asked about provider practices for prenatal smoking cessation. Adjusted prevalence ratios were calculated to examine associations between being offered NRT, selected maternal characteristics, and smoking level. Variables used in adjusted models were based on factors associated with smoking cessation during pregnancy from prior literature and included race, age, education, insurance type, and stress. Results Of 3559 women who smoked 3 months before pregnancy, 77.4% (95% CI: 74.2, 80.3) of 3rd trimester smokers and 42% (95% CI: 38.5, 46.4) of women who quit smoking during pregnancy were offered at least one cessation method. Among smokers, 19.1% (95% CI: 16.5, 22.1) were offered NRT and of these, almost all (94%) were offered another cessation method. Conclusions One in five pregnant smokers was offered NRT. About a quarter of pregnant smokers did not receive any interventions to stop smoking. There may still be reluctance to provide NRT to pregnant women, despite known harms of continued smoking during pregnancy.