Τίτλος:
Counselling for smoking cessation during pregnancy reduces tobacco-specific nitrosamine (NNAL) concentrations: A randomized controlled trial.
Περίληψη:
INTRODUCTION: Smoking cessation during pregnancy is beneficial to both the mother and child. Our objective was to assess if an intensive smoking cessation intervention for pregnant women increases: a) rates of smoking cessation, and b) reduces exposure to tobacco-specific carcinogens during pregnancy. METHODS: A two-group single-blinded parallel randomized controlled trial (RCT) was conducted involving 84 pregnant smokers in either a high intensity (n=42) or minimal contact control group (n=42). Women assigned to the high intensity smoking cessation intervention group received a single 30-minute behavioural counselling session and a tailored self-help booklet. The primary outcome measures were: 7-day point prevalence abstinence measured by selfreport and urine cotinine levels, and maternal tobacco specific carcinogens nitrosamine (NNAL) urine concentrations assessed at 32 weeks of gestation. RESULTS: A significantly greater percentage of pregnant smokers quit smoking in the high intensity group compared to the low intensity control group (45.2% vs 21.4%; p=0.001). A significant decrease in urine cotinine concentrations was documented in the experimental group (-140.74 ± 361.70 ng/mL; p=0.004), with no significant decrease documented in the control group. A significant decrease in NNAL levels was also documented in the experimental group (158.17 ± 145.03 pg/mL before, 86.43 ± 112.54 pg/mL after; p=0.032) with no significant changes in the control group. CONCLUSIONS: The high intensity intervention tested resulted in significantly greater cessation rates. Intensive smoking cessation interventions can be effective in reducing fetal exposure to NNAL. This is the first trial to report on NNAL tobacco-specific carcinogen concentrations before and after an intervention for smoking cessation during pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01210118. ABBREVIATIONS: 5Αs: ask, advise, asses, assist, arrange; GHQ: general health questionnaire; ANOVA: analysis of variance; RCT: randomized control trials; NNAL: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.
Συγγραφείς:
Loukopoulou, Andriani N.
Vardavas, Constantine I.
Farmakides, George
Rosolymos, Christos
Chrelias, Charalambos
Tzatzarakis, Manolis
Tsatsakis, Aristeidis
Myridakis, Antonis
Lyberi, Maria
Behrakis, Panagiotis K.
Περιοδικό:
European journal of midwifery
Λέξεις-κλειδιά:
pregnancy, smoking cessation, cognitivebehavioural, interventions, NNAL, tobacco-specific carcinogen
