Interventions for smoking cessation during pregnancy

SUMMARY.Maternal smoking during pregnancy has been shown to be the mostsignificant risk factor for the foetus and it is associated with complicationsduring pregnancy, unfavourable results in childbirth and avariety of health problems in newborn infants and children. Most ofthese negative effects are reversible if smoking cessation is achievedduring the first trimester of gestation. Smoking cessation has beenfound to contribute to a decrease in low birth weight and prematurityrates and reduced needs for health care in childhood. Successfulinterventions for smoking cessation can be considered cost effectivebecause, regardless of their intensity, their cost is minimal comparedwith the beneficial results. The interventions that are considered tobe the most effective are the intensive, cognitive-behavioural type,which involve face-to-face contact, more and longer sessions, andthe use of a self-help manual, and accompanied with sessions afterchildbirth to prevent a post-partum smoking relapse. There is somedebate in the international scientific community on the issue of useof medication for smoking cessation during pregnancy. Recently,the use of nicotine replacement products has been suggested,for highly dependent smokers only, after careful assessment andwith close supervision, and provided that the pregnant woman isdetermined to stop smoking. The effectiveness and safety of theseproducts, however, have not been sufficiently evaluated. Pneumon2011, 24(1):385-395.