Norwich Medical School, University of East Anglia, Norwich, UK.
School of Health Sciences, University of East Anglia, Norwich, UK.
Addict Behav. 2019 May;92:236-243. doi: 10.1016/j.addbeh.2018.12.031. Epub 2018 Dec 23.
There is no routine support to prevent postpartum smoking relapse, due to lack of effective interventions. Previous reviews have identified behaviour change techniques (BCTs) within pregnancy cessation trials to specify which components might be incorporated into more effective interventions, but no reviews have identified BCTs for prevention of smoking relapse postpartum. We reviewed BCTs and potential delivery modes, to inform future interventions.
We searched Medline and EMBASE from January 2015-May 2017; and identified trials published before 2015 by handsearching systematic reviews. We included RCTs where: i) ≥1 intervention component aimed to maintain smoking abstinence versus a less intensive intervention; ii) participants included pregnant or postpartum smoking quitters; iii) smoking status was reported in the postpartum period. We extracted trial characteristics and used the Behaviour Change Technique Taxonomy v1 to extract BCTs. We aimed to identify 'promising' BCTs i.e. those frequently occurring and present in ≥2 trials that demonstrated long-term effectiveness (≥6 months postpartum). Data synthesis was narrative.
We included 32 trials, six of which demonstrated long-term effectiveness. These six trials used self-help, mainly in conjunction with counselling, and were largely delivered remotely. We identified six BCTs as promising: 'problem solving', 'information about health consequences', 'information about social and environmental consequences', 'social support', 'reduce negative emotions' and 'instruction on how to perform a behaviour'.
Future interventions to prevent postpartum smoking relapse might include these six BCTs to maximise effectiveness. Tailored self-help approaches, with/without counselling, may be favourable modes of delivery of BCTs. Registration: PROSPERO CRD42018075677.
由于缺乏有效的干预措施，目前没有常规的支持措施来预防产后吸烟复发。之前的综述已经确定了妊娠戒烟试验中的行为改变技术（BCTs），以确定哪些组成部分可以纳入更有效的干预措施中，但没有综述确定了预防产后吸烟复发的 BCTs。我们综述了 BCTs 和潜在的传递模式，为未来的干预措施提供信息。
我们于 2015 年 1 月至 2017 年 5 月期间在 Medline 和 EMBASE 进行了检索，并通过手工检索系统评价来确定 2015 年前发表的试验。我们纳入了 RCTs，其中：i）≥1 个干预成分旨在维持吸烟戒断，而不是较不密集的干预；ii）参与者包括怀孕或产后戒烟者；iii）产后报告了吸烟状况。我们提取了试验特征，并使用行为改变技术分类 v1 提取了 BCTs。我们旨在确定“有希望”的 BCTs，即那些经常出现且在≥2 个显示长期有效性（产后≥6 个月）的试验中存在的 BCTs。数据综合是叙述性的。
我们纳入了 32 项试验，其中 6 项显示了长期有效性。这 6 项试验使用了自助，主要与咨询相结合，并且主要通过远程方式进行。我们确定了六个有希望的 BCTs：“解决问题”、“关于健康后果的信息”、“关于社会和环境后果的信息”、“社会支持”、“减少负面情绪”和“关于如何执行行为的指导”。
未来预防产后吸烟复发的干预措施可能包括这些六个 BCTs，以最大限度地提高有效性。有/没有咨询的定制自助方法可能是传递 BCTs 的有利模式。注册：PROSPERO CRD42018075677。
