Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC.
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Nicotine Tob Res. 2020 Jun 12;22(7):1187-1194. doi: 10.1093/ntr/ntz174.
Smoking during pregnancy poses serious risks to baby and mother. Few disseminable programs exist to help pregnant women quit or reduce their smoking. We hypothesized that an SMS text-delivered scheduled gradual reduction (SGR) program plus support texts would outperform SMS support messages alone.
We recruited 314 pregnant women from 14 prenatal clinics. Half of the women received theory-based support messages throughout their pregnancy to promote cessation and prevent relapse. The other half received the support messages plus alert texts that gradually reduced their smoking more than 3-5 weeks. We conducted surveys at baseline, end of pregnancy, and 3 months postpartum. Our primary outcome was biochemically validated 7-day point prevalence abstinence at late pregnancy. Our secondary outcome was reduction in cigarettes per day.
Adherence to the SGR was adequate with 70% responding to alert texts to smoke within 60 minutes. Women in both arms quit smoking at the same rate (9%-12%). Women also significantly reduced their smoking from baseline to the end of pregnancy from nine cigarettes to four; we found no arm differences in reduction.
Support text messages alone produced significant quit rates above naturally occurring quitting. SGR did not add significantly to helping women quit or reduce. Sending support messages can reach many women and is low-cost. More obstetric providers might consider having patients who smoke sign up for free texting programs to help them quit.
A disseminable texting program helped some pregnant women quit smoking.Clinical Trial Registration number: NCT01995097.
孕期吸烟对母婴都存在严重风险。目前，能够帮助孕妇戒烟或减少吸烟量的可推广项目寥寥无几。我们假设，通过短信发送有计划的逐步减少（SGR）方案并提供支持短信，会比只提供支持短信的效果更好。
我们从 14 家产前诊所招募了 314 名孕妇。其中一半的女性在整个孕期都收到基于理论的支持短信，以促进戒烟和预防复吸。另一半则收到支持短信和提醒短信，这些短信会在 3-5 周内逐渐减少她们的吸烟量。我们在基线、妊娠末期和产后 3 个月进行了调查。主要结局是在妊娠末期通过生物化学验证的 7 天点患病率（即完全戒烟）。次要结局是每天吸烟量的减少。
SGR 的依从性良好，有 70%的人在 60 分钟内对提醒短信做出反应，按时吸烟。两组女性的戒烟率相同（9%-12%）。女性在妊娠末期也显著减少了吸烟量，从每天 9 支减少到 4 支；我们没有发现两组在减少量上的差异。
仅提供支持短信就能显著提高自然戒烟率。SGR 并不能显著帮助女性戒烟或减少吸烟量。发送支持短信可以覆盖到很多女性，而且成本低廉。更多的产科医生可能会考虑让吸烟的患者注册免费的短信项目，以帮助他们戒烟。
一种可推广的短信程序帮助了一些孕妇戒烟。
NCT01995097。
