Article type
Year
Abstract
Background: A Cochrane review about smoking cessation in pregnancy concluded that interventions can reduce the proportion of smokers and the incidence of low birthweight and preterm births (Lumley et al. 2009). Another systematic review (Arblaster and colleagues 1996) suggested a number of intervention features that are promising for reducing inequalities, such as the involvement of peers.
Objectives: To assess the impact of interventions on smoking cessation in pregnancy for disadvantaged groups, and to evaluate the relative effectiveness of intervention features suggested by Arblaster and colleagues for reducing health inequalities.
Methods: Various meta-analytic models (meta-regression, multivariate multilevel modeling) assessed the relative impact of interventions on women differing in their socioeconomic status (SES) and ethnicity. The effectiveness of intervention features at reducing inequalities was also explored: using incentives; addressing the expressed concerns of pregnant smokers; involving participants' peers; and consulting women to design interventions. Some variables were addressed descriptively (e.g., young mothers as a disadvantaged group; structural measures as an intervention feature).
Results: Interventions reduced the number of women smoking in late pregnancy regardless of SES or ethnicity. Interventions with incentives were more effective than those without; no other intervention features were statistically significant predictors of effectiveness. Interventions were relatively more effective at increasing birthweight than stopping smoking altogether.
Conclusions: Smoking cessation programmes are effective for all women and should be widely implemented. Analysis is ongoing to identify promising elements for smoking cessation interventions to reduce inequalities.
References
1. LumleyJ, ChamberlainC, DowswellT, OliverS, OakleyL, WatsonL. (2009) Interventions for promoting smoking cessation during pregnancy. In: the Cochrane Database of Systematic Reviews, 2009: Issue 3. Art. No.: CD001055. DOI: 10.1002/14651858.CD001055. pub2.
2. ArblasterL. (1996) A systematic review of the effectiveness of health service interventions aimed at reducing inequalities in health. Journal of Health Services Research and Policy 1: 93-103.
Objectives: To assess the impact of interventions on smoking cessation in pregnancy for disadvantaged groups, and to evaluate the relative effectiveness of intervention features suggested by Arblaster and colleagues for reducing health inequalities.
Methods: Various meta-analytic models (meta-regression, multivariate multilevel modeling) assessed the relative impact of interventions on women differing in their socioeconomic status (SES) and ethnicity. The effectiveness of intervention features at reducing inequalities was also explored: using incentives; addressing the expressed concerns of pregnant smokers; involving participants' peers; and consulting women to design interventions. Some variables were addressed descriptively (e.g., young mothers as a disadvantaged group; structural measures as an intervention feature).
Results: Interventions reduced the number of women smoking in late pregnancy regardless of SES or ethnicity. Interventions with incentives were more effective than those without; no other intervention features were statistically significant predictors of effectiveness. Interventions were relatively more effective at increasing birthweight than stopping smoking altogether.
Conclusions: Smoking cessation programmes are effective for all women and should be widely implemented. Analysis is ongoing to identify promising elements for smoking cessation interventions to reduce inequalities.
References
1. LumleyJ, ChamberlainC, DowswellT, OliverS, OakleyL, WatsonL. (2009) Interventions for promoting smoking cessation during pregnancy. In: the Cochrane Database of Systematic Reviews, 2009: Issue 3. Art. No.: CD001055. DOI: 10.1002/14651858.CD001055. pub2.
2. ArblasterL. (1996) A systematic review of the effectiveness of health service interventions aimed at reducing inequalities in health. Journal of Health Services Research and Policy 1: 93-103.