Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Ussher, M; Lewis, S; Aveyard, P; Manyonda, I; West, R; Lewis, B; Marcus, B; Riaz, M; Taylor, A; Daley, A; Coleman, T (2015)
Publisher: England
Journal: The BMJ
Languages: English
Types: Article
Subjects: Social Support, England, Patient Compliance, Health Knowledge, Attitudes, Practice, Behavior Therapy, Motivation, Pregnancy, Infant, Newborn, Middle Aged, Treatment Outcome, Research, Intention, Prenatal Care, 1778, Exercise Therapy, Smoking Cessation, Smoking, Smoking Prevention, Health Behavior, Adolescent, Combined Modality Therapy, Adult, Female, Humans
Objective: To determine the effectiveness of a physical activity intervention for smoking cessation during pregnancy. \ud \ud Design: Parallel group, randomised controlled, multicentre trial. \ud \ud Setting: 13 hospitals in England, April 2009 to January 2014. \ud \ud Participants: 789 pregnant smokers, aged 16-50 years and at 10-24 weeks’ gestation, who smoked at least one cigarette daily and were prepared to quit smoking one week after enrollment were randomised (1:1); 785 were included in the intention to treat analyses, with 392 assigned to the physical activity group. \ud \ud Interventions: Interventions began one week before a target quit date. Participants were randomised to six weekly sessions of behavioural support for smoking cessation (control) or to this support plus 14 sessions combining supervised treadmill exercise and physical activity consultations. \ud \ud Main outcome measures: The primary outcome was continuous smoking abstinence from the target quit date until end of pregnancy, validated by exhaled carbon monoxide or salivary cotinine levels. To assess adherence, levels of moderate-vigorous intensity physical activity were self reported and in a 11.5% (n=90) random subsample of participants, physical activity was objectively measured by an accelerometer. \ud \ud Results: No significant difference was found in rates of smoking abstinence at end of pregnancy between the physical activity and control groups (8% v 6%; odds ratio 1.21, 95% confidence interval 0.70 to 2.10). For the physical activity group compared with the control group, there was a 40% (95% confidence interval 13% to 73%), 34% (6% to 69%), and 46% (12% to 91%) greater increase in self reported minutes carrying out physical activity per week from baseline to one week, four weeks, and six weeks post-quit day, respectively. According to the accelerometer data there was no significant difference in physical activity levels between the groups. Participants attended a median of four treatment sessions in the intervention group and three in the control group. Adverse events and birth outcomes were similar between the two groups, except for significantly more caesarean births in the control group than in the physical activity group (29% v 21%, P=0.023). \ud \ud Conclusion: Adding a physical activity intervention to behavioural smoking cessation support for pregnant women did not increase cessation rates at end of pregnancy. During pregnancy, physical activity is not recommended for smoking cessation but remains indicated for general health benefits. \ud \ud Trial registration: Current Controlled Trials ISRCTN48600346.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1 Kallen K. The impact of maternal smoking during pregnancy on delivery outcome. Eur J Public Health 2001;11:329-33.
    • 2 Rogers JM. Tobacco and pregnancy. Reprod Toxicol 2009;28:152-60.
    • 3 Salihu HM, Wilson RE. Epidemiology of prenatal smoking and perinatal outcomes. Early Hum Dev 2007;83:713-20.
    • 4 NHS Information Centre. Infant feeding survey 2010: early results. NHS Information Centre for Health and Social Care, 2011.
    • 5 Tong VT, Dietz PM, Morrow B, et al. Trends in smoking before, during, and after pregnancy-pregnancy risk assessment monitoring system, United States, 40 sites, 2000-2010. MMWR Surveill Summ 2013;62:1-19.
    • 6 Al-Sahab B, Saqib M, Hauser G, et al. Prevalence of smoking during pregnancy and associated risk factors among Canadian women: a national survey. BMC Pregnancy Childbirth 2010;10:24.
    • 7 Richmond R. You've come a long way baby: women and the tobacco epidemic. Addiction 2003;98:553-7.
    • 8 Chamberlain C, O'Mara-Eves A, Oliver S, et al. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev 2013;10:CD001055.
    • 9 Coleman T, Chamberlain C, Davey MA, et al. Pharmacological interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev 2012;9:CD010078.
    • 10 Haasova, M, Warren FC, Ussher M, et al. The acute efects of physical activity on cigarette cravings: systematic review and meta-analysis with individual participant data (IPD). Addiction 2012;108:26-37.
    • 11 Marcus BH, Albrecht AE, King TK, et al. The eficacy of exercise as an aid for smoking cessation in women: a randomised controlled trial. Arch Intern Med 1999;159:1229-34.
    • 12 Ussher MH, Taylor A, Faulkner G. Exercise interventions for smoking cessation. Cochrane Database Syst Rev 2012;1:CD002295.
    • 13 Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011;43:1334-59.
    • 14 Ussher M, Aveyard P, Coleman T, et al. Physical activity as an aid to smoking cessation during pregnancy: two feasibility studies. BMC Public Health 2008;8:328.
    • 15 Ussher M, Aveyard P, Manyonda I, et al. Physical activity as an aid to smoking cessation during pregnancy (LEAP) trial: study protocol for a randomized controlled trial. Trials 2012;13:186.
    • 16 Michie S, Hyder N, Walia A, et al. Development of a taxonomy of behaviour change techniques used in individual behavioural support for smoking cessation. Addict Behav 2011;36:315-9.
    • 17 Heatherton T, Kozlowski L, Frecker T, et al. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict 1991;86:1119-27.
    • 18 Blair SN, Haskell WL, Ho P, et al. Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments. Am J Epidemiol 1985;122:794-804.
    • 19 Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). J Reprod Infant Psychol 1990;8:99-107.
    • 20 Marcus BH, Selby VC, Niaura RS, et al. Self-eficacy and the stages of exercise behavior change. Res Q Exerc Sport 1992;63:60-6.
    • 21 West R, Willis N. Double-blind placebo controlled trial of dextrose tablets and nicotine patch in smoking cessation. Psychopharmacology 1998;136:201-4.
    • 22 Babor TF, de la Fuente JR, Saunders J, et al. AUDIT: the Alcohol Use Disorders Identification Test-guidelines for use in primary health care. World Health Organization, 1992.
    • 23 West R, Russell M. Pre-abstinence smoke intake and smoking motivation as predictors of severity of cigarette withdrawal symptoms. Psychopharmacology 1985;87:334-6.
    • 24 Ussher M, Beard E, Abikoye G, et al. Urge to smoke over 52 weeks of abstinence. Psychopharmacology 2013;226:83-9.
    • 25 West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction 2005;100:299-303.
    • 26 Lumley J, Chamberlain C, Dowswell T, et al. Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev 2009;3:CD001055.
    • 27 Chamberlain C, O'Mara-Eves A, Oliver S, et al. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev 2013;10:CD001055.
    • 28 Hedeker D, Mermelstein RJ, Demirtas H. Analysis of binary outcomes with missing data: missing=smoking, last observation carried forward, and a little multiple imputation. Addiction 2007;102:1564-73.
    • 29 Troiano RP, Berrigan D, Dodd KW, et al. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008;40:181-8.
    • 30 Gates S, Brocklehurst P. How should randomised trials including multiple pregnancies be analysed? BJOG 2004;111:213-9.
    • 31 Fergusson D, Aaron SD, Guyatt G, Hébert P. Post-randomisation exclusions: the intention to treat principle and excluding patients from analysis. BMJ 2002;325:652-4.
    • 32 Coleman T, Cooper S, Thornton JG, et al. Smoking, Nicotine, and Pregnancy (SNAP) trial team. A randomized trial of nicotine-replacement therapy patches in pregnancy. N Engl J Med 2012;366:808-18.
    • 33 Gavin NI, Gaynes BN, Lohr KN, et al. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005;106:1071-83.
    • 34 Hajek P, West R, Lee A, et al. Randomized controlled trial of a midwife-delivered brief smoking cessation intervention in pregnancy. Addiction 2001;96:485-94.
    • 35 Aofnso DD, De AK, Horowitz JA, et al. An international study exploring levels of postpartum depressive symptomatology. J Psychosom Res 2000;49:207-16.
    • 36 Matthey S. Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale. J Afect Disord 2004;78:269-72.
    • 37 Domenjoz I, Kayser B, Boulvain M. Efect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol 2014;211:401 (e1-11).
    • 38 Ussher M, Ah-Yoon M, West R, et al. Factors associated with exercise participation and attitudes to exercise among pregnant smokers. J Smok Cessat 2007;2:12-6.
    • 39 Harrison CL, Thompson RG, Teede HJ, et al. Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act 2011;8:19.
    • © BMJ Publishing Group Ltd 2015
  • No related research data.
  • No similar publications.