Trial reportBMJ (Clinical research ed.)2002
Self help smoking cessation in pregnancy: cluster randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Smoking cessation in pregnancy: a systematic review and meta-analysis of vulnerability approaches and expectant father involvement.Public health reviews · 2026Pooled it
- Print-based self-help interventions for smoking cessation.The Cochrane database of systematic reviews · 2019Pooled it
- Psychosocial interventions for supporting women to stop smoking in pregnancy.The Cochrane database of systematic reviews · 2017Pooled it
- A systematic review of the quality of reporting in published smoking cessation trials for pregnant women: an explanation for the evidence-practice gap?Implementation science : IS · 2014Pooled it
- Psychosocial interventions for supporting women to stop smoking in pregnancy.The Cochrane database of systematic reviews · 2013Pooled it
- Interventions for promoting smoking cessation during pregnancy.The Cochrane database of systematic reviews · 2009Pooled it
- Trial
- The We Can Quit2 Smoking Cessation Trial: Knowledge Exchange and Dissemination Following a Community-Based Participatory Research Approach.International journal of environmental research and public health · 2022Trial
- Design and study protocol of the maternal smoking cessation during pregnancy study, (M-SCOPE).BMC public health · 2011Trial
- A group randomised trial of two methods for disseminating a smoking cessation programme to public antenatal clinics: effects on patient outcomes.Tobacco control · 2006Trial
- Development and application of culturally appropriate decision aids for smoking cessation in Korea: a pragmatic clustered randomization crossover trial.Patient preference and adherence · 2016Article
- Population-based study of smoking behaviour throughout pregnancy and adverse perinatal outcomes.International journal of environmental research and public health · 2013Article
- What is the role and authority of gatekeepers in cluster randomized trials in health research?Trials · 2012Article
- Experiences of a long-term randomized controlled prevention trial in a maiden environment: Estonian Postmenopausal Hormone Therapy trial.BMC medical research methodology · 2008Article
- The influence of maternal cigarette smoking on placental pathology in pregnancies complicated by abruption.American journal of obstetrics and gynecology · 2007Article
- Sudden unexpected death in infancy: place and time of death.The Ulster medical journal · 2006Article
- A priori postulated and real power in cluster randomized trials: mind the gap.BMC medical research methodology · 2005Article
- Evaluating decision aids--where next?Health expectations : an international journal of public participation in health care and health policy · 2004Article
- CONSORT statement: extension to cluster randomised trials.BMJ (Clinical research ed.) · 2004Article
- Tobacco cessation in primary care: maximizing intervention strategies.Clinical medicine & research · 2003Review
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the effectiveness of a self help approach to smoking cessation in pregnancy.
designPragmatic cluster randomised controlled trial with community midwife as the unit of randomisation.
settingThree NHS hospital trusts in England.
participants1527 women who smoked at the start of pregnancy.
interventionA series of five self help booklets comprising a step by step programme to increase motivation for quitting smoking and to teach strategies for cessation and relapse prevention. The first booklet was given to the women by a midwife at the earliest opportunity in antenatal care, together with a booklet for partners, family members, and friends. The remaining four booklets were mailed directly to the women.
main outcome measuresThe primary outcome was smoking cessation validated by cotinine measurement at the end of the second trimester of pregnancy. Other outcomes were self reported smoking status and cigarette consumption among daily smokers. Qualitative data exploring the acceptability of the intervention and the way that smoking cessation advice was delivered in both trial arms were also collected.
resultsSmoking cessation rates were low: the cotinine validated rates were 18.8% (113/600) in the intervention group and 20.7% (144/695) in the normal care group (difference 1.9%, 95% confidence intervals -3.5% to 7.3%). Self reported quit rates were higher. In the intervention group, 156 (25.6%) women reported not smoking for at least seven days, compared with 207 (29.1%) in the normal care group. In both groups, median self reported daily cigarette consumption among daily smokers was 10 cigarettes per day. Pregnant women and midwives approved of the intervention, but the way in which it was delivered varied considerably. For the primary smoking outcome, the degree of clustering at the midwife level was non-trivial (intracluster correlation coefficient 0.031).
conclusionThe self help intervention was acceptable but ineffective when implemented during routine antenatal care. More intensive and complex interventions, appropriately targeted and tailored, need to be developed and evaluated. Validated smoking cessation rates among pregnant women are substantially lower than the self reported rates on which current smoking policy is based.
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