Division of Primary Care, University of Nottingham, Nottingham, UK.
Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Addiction. 2019 Sep;114(9):1651-1658. doi: 10.1111/add.14662. Epub 2019 Jun 30.
Due to concerns about increased exposure to nicotine, pregnant women using nicotine replacement therapy (NRT) to stop smoking are usually advised to stop using NRT if they relapse to smoking. This study investigated whether this is justified. We compared changes in saliva cotinine from baseline to 2 weeks post-target quit date pregnant smokers who relapsed to smoking and continued to use their patches having been assigned to use nicotine patches or placebo.
Controlled pre-post design stratified by intervention condition from the 'Study of Nicotine Patch in Pregnancy', a randomized, placebo-controlled trial.
A sample of 268 pregnant women, assigned placebo (n = 122) or nicotine (n = 146) patches, who returned for further supplies of patches and who reported any smoking in the week prior to a visit at 2 weeks after their target quit date.
Saliva cotinine concentrations were measured at baseline and 2 weeks after participants' target quit dates. Any smoking in the previous week was assessed by self-report, validated by expired air carbon monoxide (CO).
There was no change in saliva cotinine concentrations between baseline and 2 weeks post-target quit date in saliva cotinine concentration in the nicotine patch group [ratio of geometric means = 0.94, 95% confidence interval (CI) = 0.83 to 1.07; P = 0.37, Bayes factor = 0.15]. However, there was a reduction in reported number of cigarettes smoked/day (mean difference -6, 95% CIs -7 to -5, P < 0.001) and in CO concentrations (mean difference -3.0 parts per million, 95% CIs -4.2 to -1.9, P < 0.001). These changes were not significantly different from changes in the placebo group except for cigarette consumption, which reduced more in the nicotine group (P = 0.046).
In women trying to stop smoking with the aid of a nicotine patch but having smoked at 2 weeks post-target quit, their nicotine concentration did not change from baseline, but they reported smoking fewer cigarettes and had lower carbon monoxide concentrations.
由于担心尼古丁暴露增加，使用尼古丁替代疗法（NRT）戒烟的孕妇如果复吸，通常会被建议停止使用 NRT。本研究旨在探讨这是否合理。我们比较了在目标戒烟日期后 2 周，复吸并继续使用贴片的孕妇吸烟者与随机分配使用尼古丁贴片或安慰剂的孕妇吸烟者之间唾液可替宁浓度从基线到 2 周的变化。
这是一项来自“妊娠期间尼古丁贴片研究”的对照前后设计，为一项随机、安慰剂对照试验，根据干预条件进行分层。
共有 268 名孕妇参与了研究，随机分配接受安慰剂（n=122）或尼古丁贴片（n=146），这些孕妇返回领取进一步的贴片，并报告在目标戒烟日期后 2 周内的前一周有任何吸烟情况。
在基线和参与者目标戒烟日期后 2 周测量唾液可替宁浓度。前一周的任何吸烟情况都通过自我报告进行评估，并用呼出的一氧化碳（CO）进行验证。
在尼古丁贴片组中，唾液可替宁浓度在基线和目标戒烟日期后 2 周之间没有变化[几何均数比=0.94，95%置信区间（CI）=0.83 至 1.07；P=0.37，贝叶斯因子=0.15]。然而，报告的每日吸烟量（平均差-6，95%CI-7 至-5，P<0.001）和 CO 浓度（平均差-3.0 个百万分率，95%CI-4.2 至-1.9，P<0.001）均有所降低。除了吸烟量外，这些变化与安慰剂组没有显著差异，而尼古丁组的吸烟量减少更多（P=0.046）。
在使用尼古丁贴片帮助戒烟但在目标戒烟日期后 2 周内复吸的女性中，她们的尼古丁浓度从基线没有变化，但报告的吸烟量减少，CO 浓度降低。
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