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Nicotine & Tobacco Research Advance Access originally published online on April 7, 2009
Nicotine & Tobacco Research 2009 11(5):514-518; doi:10.1093/ntr/ntp032
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Adherence to nicotine replacement therapy among pregnant smokers

Laura J. Fish, Bercedis L. Peterson, Rebecca J. Namenek Brouwer, Pauline Lyna, Cheryl A. Oncken, Geeta K. Swamy, Evan R. Myers, Pamela K. Pletsch and Kathryn I. Pollak

Laura J. Fish, Ph.D., Department of Community and Family Medicine, Duke University Medical Center and Cancer Prevention, Detection, and Control Research Program, Duke Comprehensive Cancer Center, Durham, NC
Bercedis L. Peterson, Ph.D., Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC
Rebecca J. Namenek Brouwer, M.S., Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
Pauline Lyna, M.P.H., Cancer Prevention, Detection, and Control Research Program, Duke Comprehensive Cancer Center, Durham, NC
Cheryl A. Oncken, M.D., M.P.H., Department of Medicine, University of Connecticut Health Center, Farmington, CT
Geeta K. Swamy, M.D., Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
Evan R. Myers, M.D., M.P.H., Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
Pamela K. Pletsch, Ph.D., R.N., School of Nursing, University of Wisconsin, Madison, WI
Kathryn I. Pollak, Ph.D., Department of Community and Family Medicine, Duke University Medical Center and Cancer Prevention, Detection, and Control Research Program, Duke Comprehensive Cancer Center, Durham, NC

Corresponding Author: Laura J. Fish, Ph.D., Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, 2424 Erwin Road, Suite 602, Durham, NC 27705, USA. Telephone: 919-681-3820; Fax: 919-681-4785; E-mail: fish0006{at}mc.duke.edu


  Abstract

Introduction: This secondary analysis examined the association between adherence to nicotine replacement therapy (NRT) and smoking cessation among pregnant smokers enrolled in Baby Steps, an open-label randomized controlled trial testing cognitive-behavioral therapy (CBT) versus CBT plus NRT.

Method: The analysis included only women who received NRT for whom we had complete data (N = 104). Data came from daily calendars created from recordings of counseling sessions and from telephone surveys at baseline and 38 weeks gestation.

Results: Overall, 29% of the 104 women used NRT for the recommended 6 weeks and 41% used NRT as directed in the first 48 hr after a quit attempt. Ordinal logistic regression modeling indicated that using NRT as directed in the first 48 hr and having made a previous quit attempt were the strongest predictors of longer NRT use. Univariate analyses suggested that primigravid women and women who used NRT longer were more likely to report quitting at 38 weeks gestation.

Discussion: Findings indicated that adherence to NRT is low among pregnant smokers, but adherence was a predictor of cessation. Future trials should emphasize adherence, particularly more days on NRT, to promote cessation during pregnancy.

Received: April 1, 2008; Accepted: September 14, 2008
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