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

Vaz, Luis R.; Aveyard, Paul; Cooper, Sue; Leonardi-Bee, Jo; Coleman, Tim

Abstract

Introduction

In non-pregnant ‘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 (beta -0.08, 95%CI -0.15 to -0.01) and randomisation to NRT (beta 2.59, 95%CI 1.50 to 3.68). Adherence during both treatment months was associated with being randomised to NRT (beta 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 one month (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.

Citation

Vaz, L. R., Aveyard, P., Cooper, S., Leonardi-Bee, J., & Coleman, T. (2016). The association between treatment adherence to nicotine patches and smoking cessation in pregnancy: a secondary analysis of a randomised controlled trial. Nicotine & Tobacco Research, 18(10), https://doi.org/10.1093/ntr/ntw080

• Journal Article Type: Article
• Acceptance Date: Feb 21, 2016
• Publication Date: Mar 31, 2016
• Deposit Date: Jun 1, 2016
• Publicly Available Date: Jun 1, 2016
• Journal: Nicotine & Tobacco Research
• Print ISSN: 1462-2203
• Electronic ISSN: 1469-994X
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 10
• DOI: https://doi.org/10.1093/ntr/ntw080
• Public URL: https://nottingham-repository.worktribe.com/output/778570
• Publisher URL: http://ntr.oxfordjournals.org/content/early/2016/03/30/ntr.ntw080.abstract
• Contract Date: Jun 1, 2016