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Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

Author

Listed:
  • Gillian S. Gould

    (School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia)

  • Alys Havard

    (Centre for Big Data Research in Health, UNSW Sydney, Sydney NSW 2052, Australia)

  • Ling Li Lim

    (School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia)

  • The PSANZ Smoking in Pregnancy Expert Group

    (Perinatal Society of Australia and New Zealand, Mornington, Victoria 3931, Australia)

  • Ratika Kumar

    (School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia)

Abstract

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.

Suggested Citation

  • Gillian S. Gould & Alys Havard & Ling Li Lim & The PSANZ Smoking in Pregnancy Expert Group & Ratika Kumar, 2020. "Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators," IJERPH, MDPI, vol. 17(6), pages 1-34, March.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:6:p:2034-:d:334323
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    References listed on IDEAS

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    2. Lin Zhang & Xing-Huan Wang & Xin-Min Zheng & Tong-Zu Liu & Wei-Bin Zhang & Hang Zheng & Mi-Feng Chen, 2015. "Maternal Gestational Smoking, Diabetes, Alcohol Drinking, Pre-Pregnancy Obesity and the Risk of Cryptorchidism: A Systematic Review and Meta-Analysis of Observational Studies," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-17, March.
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    6. Gillian S. Gould & Yael Bar Zeev & Laura Tywman & Christopher Oldmeadow & Simon Chiu & Marilyn Clarke & Billie Bonevski, 2017. "Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey," IJERPH, MDPI, vol. 14(12), pages 1-11, December.
    7. Yael Bar-Zeev & Michelle Bovill & Billie Bonevski & Maree Gruppetta & Jennifer Reath & The ICAN QUIT in Pregnancy Pilot Group & Gillian S. Gould, 2017. "Assessing and Validating an Educational Resource Package for Health Professionals to Improve Smoking Cessation Care in Aboriginal and Torres Strait Islander Pregnant Women," IJERPH, MDPI, vol. 14(10), pages 1-15, September.
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