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BMC Public Health
Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

Physical activity as an aid to smoking cessation during pregnancy: Two feasibility studies

Authors: Michael Ussher, Paul Aveyard, Tim Coleman, Lianne Straus, Robert West, Bess Marcus, Beth Lewis, Isaac Manyonda

Published in: BMC Public Health | Issue 1/2008

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Abstract

Background

Pharmacotherapies for smoking cessation have not been adequately tested in pregnancy and women are reluctant to use them. Behavioural support alone has a modest effect on cessation rates; therefore, more effective interventions are needed. Even moderate intensity physical activity (e.g. brisk walk) reduces urges to smoke and there is some evidence it increases cessation rates in non-pregnant smokers. Two pilot studies assessed i) the feasibility of recruiting pregnant women to a trial of physical activity for smoking cessation, ii) adherence to physical activity and iii) womens' perceptions of the intervention.

Methods

Pregnant smokers volunteered for an intervention combining smoking cessation support, physical activity counselling and supervised exercise (e.g. treadmill walking). The first study provided six weekly treatment sessions. The second study provided 15 sessions over eight weeks. Physical activity levels and continuous smoking abstinence (verified by expired carbon monoxide) were monitored up to eight months gestation.

Results

Overall, 11.6% (32/277) of women recorded as smokers at their first antenatal booking visit were recruited. At eight months gestation 25% (8/32) of the women achieved continuous smoking abstinence. Abstinent women attended at least 85% of treatment sessions and 75% (6/8) achieved the target level of 110 minutes/week of physical activity at end-of-treatment. Increased physical activity was maintained at eight months gestation only in the second study. Women reported that the intervention helped weight management, reduced cigarette cravings and increased confidence for quitting.

Conclusion

It is feasible to recruit pregnant smokers to a trial of physical activity for smoking cessation and this is likely to be popular. A large randomised controlled trial is needed to examine the efficacy of this intervention.
Literature
1.
Bolling K, Grant C, Hamlyn B, Thornton A: Infant Feeding Survey 2005. 2007, London: The Information Centre
2.
England LJ, Grauman A, Qian C, Wilkins DG, Schisterman EF, Yu KF, Levine RJ: Misclassification of maternal smoking status and its effects on an epidemiologic study of pregnancy outcomes. Nicotine Tob Res. 2007, 9: 1005-1013. 10.1080/14622200701491255.CrossRefPubMed
3.
Castles A, Adams EK, Melvin CL, Kelsch C, Boulton ML: Effects of smoking during pregnancy: five meta-analyses. Am J Prev Med. 1999, 16: 208-215. 10.1016/S0749-3797(98)00089-0.CrossRefPubMed
4.
West R: Smoking cessation and pregnancy. Fet Mat Med Rev. 2002, 13: 181-194. 10.1017/S0965539502000335.CrossRef
5.
Ananth CV, Smulian JC, Demissie K, Vintzileos AM, Knuppel RA: Placental abruption among singleton and twin births in the United States: risk factor profiles. Am J Epid. 2001, 153: 771-778. 10.1093/aje/153.8.771.CrossRef
6.
Toivonen S, Heinonen S, Anttila M, Kosma VM, Saarikoski S: Reproductive risk factors, Doppler findings, and outcome of affected births in placental abruption: a population-based analysis. Am J Perinat. 2002, 19: 451-456. 10.1055/s-2002-36868.CrossRef
7.
Batstra L, Hadders-Algra M, Neeleman J: Effect of antenatal exposure to maternal smoking on behavioural problems and academic achievement in childhood: prospective evidence from a Dutch birth cohort. Early Hum Dev. 2003, 75: 21-33. 10.1016/j.earlhumdev.2003.09.001.CrossRefPubMed
8.
Buka SL, Shenassa ED, Niaura R: Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: a 30-year prospective study. Am J Psych. 2003, 160: 1978-1984. 10.1176/appi.ajp.160.11.1978.CrossRef
9.
10.
Royal College of Physicians: Smoking and the young: a report of a working party of the Royal College of Physicians. 1992, London: Royal College of Physicians
11.
Wideroe M, Vik T, Jacobsen G, Bakketeig LS: Does maternal smoking during pregnancy cause childhood overweight?. Paediatr Perinat Epidemiol. 2003, 17: 171-199. 10.1046/j.1365-3016.2003.00481.x.CrossRefPubMed
12.
Owen L, Penn G: Smoking and pregnancy: A survey of knowledge attitudes and behaviour, 1992–1999. 1999, London: Health Development Agency
13.
Graham H: Gender and class as dimensions of smoking behaviour in Britain: insights from a survey of mothers. Soc Sci Med. 1994, 38: 691-698. 10.1016/0277-9536(94)90459-6.CrossRefPubMed
14.
Cahill K, Stead LF, Lancaster T: Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2007, 1: CD006103-PubMed
15.
Hughes JR, Stead LF, Lancaster T: Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2007, 1: CD000031-PubMed
16.
Silagy C, Lancaster T, Stead L, Mant D, Fowler G: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2004, 3: CD000146-PubMed
17.
Pollak KI, Oncken CA, Lipkus IM, Lyna P, Swamy GK, Pletsch PK, Peterson BL, Heine RP, Brouwer RJ, Fish L, Myers ER: Nicotine replacement and behavioral therapy for smoking cessation in pregnancy. Am J Prev Med. 2007, 33: 297-305. 10.1016/j.amepre.2007.05.006.CrossRefPubMedPubMedCentral
18.
Coleman T: Reducing harm from tobacco smoke exposure during pregnancy. Birth Defects Res C Embryo Today. 2008, 84: 73-79. 10.1002/bdrc.20115.CrossRefPubMed
19.
20.
Lumley J, Oliver S, Waters E: Interventions for promoting smoking cessation during Pregnancy. Cochrane Database Syst Rev. 2004, 4: CD001055-PubMed
21.
Hughes JR, Keely J, Naud S: Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004, 99: 29-38. 10.1111/j.1360-0443.2004.00540.x.CrossRefPubMed
22.
Taylor AH, Ussher MH, Faulkner G: The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review. Addiction. 2007, 102: 534-543. 10.1111/j.1360-0443.2006.01739.x.CrossRefPubMed
23.
Marcus BH, Lewis BA, Hogan J, King TK, Albrecht AE, Bock B, Parisi AF, Niaura R, Abrams DB: The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: a randomized controlled trial. Nicotine Tob Res. 2005, 7: 871-880. 10.1080/14622200500266056.CrossRefPubMed
24.
Artal R, O'Toole M: Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003, 37: 6-12. 10.1136/bjsm.37.1.6.CrossRefPubMedPubMedCentral
25.
Pomerleau CS, Brouwer RJ, Jones LT: Weight concerns in women smokers during pregnancy and postpartum. Addict Behav. 2000, 25: 759-767. 10.1016/S0306-4603(00)00086-1.CrossRefPubMed
26.
Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. BMJ. 2000, 321 (7262): 694-696. 10.1136/bmj.321.7262.694.CrossRefPubMedPubMedCentral
27.
Thomas S, Reading J, Shephard RJ: Revision of the physical activity readiness questionnaire. Can J Sport Sci. 1992, 17: 338-345.PubMed
28.
29.
Pollak KI, Oncken CA, Lipkus IM, Peterson BL, Swamy GK, Pletsch PK, Lyna P, Namenek Brouwer RJ, Fish LJ, Myers ER: Challenges and solutions for recruiting pregnant smokers into a nicotine replacement therapy trial. Nicotine Tob Res. 2006, 8: 547-554. 10.1080/14622200600789882.CrossRefPubMed
30.
Health Education Authority: Helping pregnant smokers quit: training for health professionals. 1994, London: Health Education Authority
31.
Melvin CL, Tucker P: Measurement and definition for smoking cessation intervention research: the Smoke-Free Families experience. Tob Control. 2000, 9 Suppl 3: III87-III90.PubMed
32.
Hajek P, Stead L, West R, Jarvis M: Relapse prevention interventions for smoking cessation. Cochrane Database Syst Rev. 2005, 1: CD003999-PubMed
33.
Mullen PD: How can more smoking suspension during pregnancy become lifelong abstinence? Lessons learned about predictors, interventions, and gaps in our accumulated knowledge. Nicotine Tob Res. 2004, 6 (Suppl 2): 217-238. 10.1080/14622200410001669150.CrossRef
34.
Health Development Agency: Standard for training in smoking cessation. 2003, London: Health Development Agency
35.
Borg GAV: Borg's Perceived Exertion and Pain Scales. 1998, Human Kinetics: Champaign, Illinois
36.
Marcus BH, Forsyth LH: Motivating people to be physically active. 2003, Champaign, Illinois: Human Kinetics
37.
Ussher M, West R, McEwen A, Taylor A, Steptoe A: Efficacy of exercise counselling as an aid for smoking cessation: a randomized controlled trial. Addiction. 2003, 98: 523-532. 10.1046/j.1360-0443.2003.00346.x.CrossRefPubMed
38.
Mottola MF, Wolfe LA: Active living and pregnancy. Toward Active Living. Edited by: Quinney HA, Gauvin L, Wall AET. 1992, Champaign, Illinois: Human Kinetics, 131-159.
39.
Rodriguez A, Bohlin G, Lindmark G: Psychosocial predictors of smoking and exercise during pregnancy. J Repro Inf Psyc. 2000, 18: 203-233. 10.1080/713683039.CrossRef
40.
Hanlon T: Fit for two: The official YMCA Prenatal Exercise Guide. 1995, Champaign Ilinois: Human Kinetics
41.
Ogita S, Matsuo S, Oka T, Kawabata R, Matsumoto M, Fujino Y, Uramae Y, Iwanaga K, Fukuoka M: Significance of exercise and bed rest in pregnancy-pregnancy and walking. Ann Physiol Anthropol. 1989, 8: 13-9.CrossRefPubMed
42.
Tudor-Locke C, Bassett DR: How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med. 2004, 34: 1-8. 10.2165/00007256-200434010-00001.CrossRefPubMed
43.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO: The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991, 86: 1119-1127. 10.1111/j.1360-0443.1991.tb01879.x.CrossRefPubMed
44.
West R, Willis N: Double-blind placebo controlled trial of dextrose tablets and nicotine patch in smoking cessation. Psychopharmacology. 1998, 136: 201-204. 10.1007/s002130050557.CrossRefPubMed
45.
SRNT Subcommittee on Biochemical Verification: Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002, 4: 149-159. 10.1080/14622200210123581.CrossRef
46.
West R, Hajek P: Evaluation of the Mood and Physical Symptoms Scale (MPSS) to assess cigarette withdrawal. Psychopharmacology. 2004, 177: 195-199. 10.1007/s00213-004-1923-6.CrossRefPubMed
47.
Blair SN, Haskell WL, Ho P, Paffenbarger P, Vranizan KM, Farquhar JW, Wood PD: Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments. Am J Epidemiol. 1985, 122: 794-804.PubMed
48.
Poudevigne MS, O'Connor PJ: Physical activity and mood during pregnancy. Med Sci Sports Exerc. 2005, 37: 74-80. 10.1249/01.mss.0000174907.27818.ff.CrossRef
49.
Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006, 3: 77-101. 10.1191/1478088706qp063oa.CrossRef
50.
Higgins ST, Heil SH, Badger GJ, Mongeon JA, Solomon LJ, McHale L, Bernstein IM: Biochemical verification of smoking status in pregnant and recently postpartum women. Exp Clin Psychopharmacol. 2007, 15: 58-66. 10.1037/1064-1297.15.1.58.CrossRefPubMed
51.
Ussher M, Ah-Yoon M, West R, Straus L: Factors associated with exercise participation and attitudes to exercise among pregnant smokers. J Smok Cess. 2007, 2: 12-16. 10.1375/jsc.2.1.12.CrossRef
52.
Sproaton K, Mindell J: Health Survey for England 2004: Health of Ethnic Minorities. 2006, London: The Information Centre
53.
Ussher M, Etter JF, West R: Perceived barriers to and benefits of attending a stop smoking course during pregnancy. Patient Educ Couns. 2006, 61: 467-472. 10.1016/j.pec.2005.06.021.CrossRefPubMed
54.
Mullen PD, Carbonari JP, Tabak ER, Glenday MC: Improving disclosure of smoking by pregnant women. Am J Obstet Gynecol. 1991, 165: 409-413.CrossRefPubMed
55.
Taylor T, Hajek P: Smoking cessation services for pregnant women. 2001, London: Health Development Agency
56.
Coleman T, Thornton J, Britton J, Lewis S, Watts K, Coughtrie MW, Mannion C, Marlow N, Godfrey C: Protocol for the smoking, nicotine and pregnancy (SNAP) trial: double-blind, placebo-randomised, controlled trial of nicotine replacement therapy in pregnancy. BMC Health Serv Res. 2007, 7: 2-10.1186/1472-6963-7-2.CrossRefPubMedPubMedCentral
57.
Ruggiero L, Webster K, Peipert JF, Wood C: Identification and recruitment of low-income pregnant smokers: who are we missing?. Addict Behav. 2003, 28: 1497-1505. 10.1016/S0306-4603(02)00269-1.CrossRefPubMed
58.
Ruggiero L, de Groot M: Smoking patterns of low-income ethnoculturally diverse pregnant women: are we casting the net wide enough?. Addict Behav. 1998, 23: 549-554. 10.1016/S0306-4603(98)00013-6.CrossRefPubMed
59.
Windsor RA, Li CQ, Boyd NR, Hartmann KE: The use of significant reduction rates to evaluate health education methods for pregnant smokers: a new harm reduction behavioral indicator?. Health Educ Beh. 1999, 26: 648-662. 10.1177/109019819902600506.CrossRef
60.
deRuiter W, Faulkner G: Tobacco harm reduction strategies: the case for physical activity. Nicotine Tob Res. 2006, 8: 157-168. 10.1080/14622200500494823.CrossRefPubMed
61.
Lewis BA, Marcus BH, Pate RR, Dunn AL: Psychosocial mediators of physical activity behavior among adults and children. Am J Prev Med. 2002, 23 (Suppl 2): 26-35. 10.1016/S0749-3797(02)00471-3.CrossRefPubMed
Metadata
Title
Physical activity as an aid to smoking cessation during pregnancy: Two feasibility studies
Authors
Michael Ussher
Paul Aveyard
Tim Coleman
Lianne Straus
Robert West
Bess Marcus
Beth Lewis
Isaac Manyonda
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-328

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