bmj.h2145.full.pdf (439.15 kB)
Physical activity for smoking cessation in pregnancy: randomised controlled trial
journal contribution
posted on 2020-09-18, 11:35 authored by Michael Ussher, Sarah Lewis, Paul Aveyard, Isaac Manyonda, Robert West, Beth Lewis, Bess Marcus, Muhammad Riaz, Adrian Taylor, Amanda DaleyAmanda Daley, Tim ColemanObjective: To determine the effectiveness of a physical activity intervention for smoking cessation during pregnancy.
Design: Parallel group, randomised controlled, multicentre trial.
Setting: 13 hospitals in England, April 2009 to January 2014.
Participants: 789 pregnant smokers, aged 16-50 years and at 10-24 weeks’ gestation, who smoked at least one cigarette daily and were prepared to quit smoking one week after enrollment were randomised (1:1); 785 were included in the intention to treat analyses, with 392 assigned to the physical activity group.
Interventions: Interventions began one week before a target quit date. Participants were randomised to six weekly sessions of behavioural support for smoking cessation (control) or to this support plus 14 sessions combining supervised treadmill exercise and physical activity consultations.
Main outcome measures: The primary outcome was continuous smoking abstinence from the target quit date until end of pregnancy, validated by exhaled carbon monoxide or salivary cotinine levels. To assess adherence, levels of moderate-vigorous intensity physical activity were self reported and in a 11.5% (n=90) random subsample of participants, physical activity was objectively measured by an accelerometer.
Results: No significant difference was found in rates of smoking abstinence at end of pregnancy between the physical activity and control groups (8% v 6%; odds ratio 1.21, 95% confidence interval 0.70 to 2.10). For the physical activity group compared with the control group, there was a 40% (95% confidence interval 13% to 73%), 34% (6% to 69%), and 46% (12% to 91%) greater increase in self reported minutes carrying out physical activity per week from baseline to one week, four weeks, and six weeks post-quit day, respectively. According to the accelerometer data there was no significant difference in physical activity levels between the groups. Participants attended a median of four treatment sessions in the intervention group and three in the control group. Adverse events and birth outcomes were similar between the two groups, except for significantly more caesarean births in the control group than in the physical activity group (29% v 21%, P=0.023).
Conclusion: Adding a physical activity intervention to behavioural smoking cessation support for pregnant women did not increase cessation rates at end of pregnancy. During pregnancy, physical activity is not recommended for smoking cessation but remains indicated for general health benefits.
Trial registration: Current Controlled Trials ISRCTN48600346.
Funding
NIHR health technology assessment programme (grant 07.01.14).
History
School
- Sport, Exercise and Health Sciences
Published in
BMJVolume
350Issue
8010Publisher
BMJ Publishing GroupVersion
- VoR (Version of Record)
Rights holder
© BMJ Publishing Group LtdPublisher statement
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.Acceptance date
2015-03-23Publication date
2015-05-14Copyright date
2015ISSN
1756-1833eISSN
1756-1833Publisher version
Language
- en
Article number
h2145Usage metrics
Categories
No categories selectedKeywords
Science & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal MedicineAdolescentAdultBehavior TherapyCombined Modality TherapyEnglandExercise TherapyFemaleHealth BehaviorHealth Knowledge, Attitudes, PracticeHumansInfant, NewbornIntentionMiddle AgedMotivationPatient CompliancePregnancyPrenatal CareSmokingSmoking CessationSmoking PreventionSocial SupportTreatment OutcomeClinical SciencesPublic Health and Health Services
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC