NCT00224419

Brief Summary

Nicotine dependence has not been sufficiently addressed in current state-of-the-science cessation interventions for pregnant smokers. The weight of the evidence from the general population of smokers suggests that nicotine replacement therapies may be beneficial cessation aids for pregnant smokers who are unable to stop smoking. The tremendous potential of these therapies for promoting smoking cessation among pregnant women creates a pressing need for decision tools and protocols to encourage treatment adherence that is essential for rigorous evaluation of the effectiveness of OTC NRT when provided as part of prenatal care. The results of this research could be directly translated to the improvement of obstetrical care providers' clinical practices. Medically supervised use of OTC NRT by pregnant smokers is an alternative to continued smoking that has the potential to substantially increase rates of smoking cessation during pregnancy.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
181

participants targeted

Target at P50-P75 for phase_4

Geographic Reach
1 country

2 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2003

Completed
2.3 years until next milestone

First Submitted

Initial submission to the registry

September 21, 2005

Completed
2 days until next milestone

First Posted

Study publicly available on registry

September 23, 2005

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2006

Completed
Last Updated

July 21, 2014

Status Verified

April 1, 2009

Enrollment Period

3.2 years

First QC Date

September 21, 2005

Last Update Submit

July 18, 2014

Conditions

Keywords

Smoking cessationPregnancyNicotine replacement therapyMotivational interviewing

Outcome Measures

Primary Outcomes (1)

  • Biochemically-validated smoking cessation

    middle and late pregnancy

Secondary Outcomes (1)

  • Biochemically-validated smoking cessation

    3 months postpartum

Study Arms (2)

1 - CBT Counseling

ACTIVE COMPARATOR

Participants in this arm received a tailored CBT (TCBT) intervention that included: a written self-help guide, feedback about the importance of reducing nicotine exposure to the fetus, 5 face to face and 1 telephone counseling session.

Behavioral: Motivational interviewing for smoking cessationBehavioral: Cognitive behaviors therapy

2 - Counseling + NRT

EXPERIMENTAL

Women in this arm received the TCBT described in Arm 1, plus their choice of NRT. To minimize fetal exposure to nicotine for women in the TCBT+NRT arm, the dose of NRT are customized to the woman's current level of smoking. Women who smoke 5-10 cigarettes a day will be given the 14 mg patch or instructed to use one 2 mg lozenge or 2 mg piece of gum to replace each cigarette she usually smokes per day. Those who smoke 11 cigarettes or more per day will be given the 21 mg patch or instructed to use no more than one lozenge (2 mg) or piece of gum (2 mg) to replace each cigarette she usually smokes per day, not to exceed 15 lozenges or pieces of gum per day.

Behavioral: Motivational interviewing for smoking cessationDrug: CBT + NRT

Interventions

All participants received a tailored CBT (TCBT) intervention that included: a written self-help guide, info about the importance of reducing nicotine exposure to the fetus, 5 face to face and 1 telephone counseling session. Women in the TCBT + NRT arm were guided through a process of deciding on nicotine gum, lozenge or patch. To minimize fetal exposure, the dose of NRT was customized to the woman's current level of smoking. Women who smoked 5-10 cigarettes a day were given the 14 mg patch or instructed to use one 2 mg lozenge or 2 mg piece of gum to replace each cigarette she usually smoked per day. Those who smoked 11 cigarettes or more per day were given the 21 mg patch or instructed to use no more than one lozenge (2 mg) or piece of gum (2 mg) to replace each cigarette she usually smoked per day, not to exceed 15 lozenges or pieces of gum per day.

Also known as: Nicoderm CQ (patch), Nicorertte (gum), Commit (lozenge)
1 - CBT Counseling2 - Counseling + NRT

6 counseling sessions delivered over the phone or in person

1 - CBT Counseling

Includes CBT from arm 1 plus choice of NRT (lozenge, gum, or patch) tailored to smoking amount

Also known as: Nicoderm CQ (patch), Nicorette (gum), Commit (lozenge)
2 - Counseling + NRT

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Be at least 18 years of age
  • Be between 13 and 25 weeks of pregnancy
  • Be receiving prenatal care at one of the participating clinics
  • Have smoked at least 100 cigarettes in their lifetime
  • Be currently smoking and have smoked at least 5 cigarettes per day in the past 7 days
  • Speak and write English

You may not qualify if:

  • Evidence of cognitive or mental health problems
  • Evidence of possible drug or alcohol addiction
  • Documented history in medical chart of mental retardation, significant chronic or recurrent psychiatric disorder such as schizophrenia or severe depression, history of cardiac arrhythmias, history of myocardial infarction within the past 6 months, history of previous pregnancy with congenital anomaly,family history of congenital anomalies
  • Complications of pregnancy during the current pregnancy, including: threatened miscarriage, congenital anomalies, unexplained vaginal bleeding, pelvic or abdominal surgical procedures, deep venous thrombosis, malignancy

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Duke University Medical Center

Durham, North Carolina, 27710, United States

Location

Womack Army Medical Center

Fayetteville, North Carolina, 28310, United States

Location

Related Publications (5)

  • Pletsch PK, Pollak KI, Peterson BL, Park J, Oncken CA, Swamy GK, Lyna P. Olfactory and gustatory sensory changes to tobacco smoke in pregnant smokers. Res Nurs Health. 2008 Feb;31(1):31-41. doi: 10.1002/nur.20229.

    PMID: 18161772BACKGROUND
  • 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 Aug;8(4):547-54. doi: 10.1080/14622200600789882.

    PMID: 16920652BACKGROUND
  • Bursey-Reddick, K, Swamy, GK, Brouwer, RN, Pollak, KI, Myers, ER. (2006). Comparison of Self-Reported Smoking Status and Anonymous Urinary Cotinine Testing in Pregnancy. American Journal of Obstetrics & Gynecology, 193 Supplement 6:S107.

    BACKGROUND
  • 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 Oct;33(4):297-305. doi: 10.1016/j.amepre.2007.05.006.

  • Swamy GK, Roelands JJ, Peterson BL, Fish LJ, Oncken CA, Pletsch PK, Myers ER, Whitecar PW, Pollak KI. Predictors of adverse events among pregnant smokers exposed in a nicotine replacement therapy trial. Am J Obstet Gynecol. 2009 Oct;201(4):354.e1-7. doi: 10.1016/j.ajog.2009.06.006. Epub 2009 Aug 7.

MeSH Terms

Conditions

SmokingSmoking Cessation

Interventions

Motivational InterviewingNicotineTransdermal PatchChewing GumNicotine Replacement TherapyNicotine Chewing Gum

Condition Hierarchy (Ancestors)

BehaviorHealth Behavior

Intervention Hierarchy (Ancestors)

Directive CounselingCounselingMental Health ServicesBehavioral Disciplines and ActivitiesHealth ServicesHealth Care Facilities Workforce and ServicesSolanaceous AlkaloidsAlkaloidsHeterocyclic CompoundsPyridinesHeterocyclic Compounds, 1-RingEquipment and SuppliesPlant GumsBiopolymersPolymersMacromolecular SubstancesPolysaccharidesCarbohydratesPlant ExudatesBiological ProductsComplex MixturesCandyFoodDiet, Food, and NutritionPhysiological PhenomenaFood and BeveragesDrug TherapyTherapeuticsTobacco Use Cessation Devices

Study Officials

  • Evan Myers, MD, MPH

    Duke University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

September 21, 2005

First Posted

September 23, 2005

Study Start

June 1, 2003

Primary Completion

August 1, 2006

Last Updated

July 21, 2014

Record last verified: 2009-04

Locations