Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data from a randomized controlled trial.
journal contributionposted on 26.07.2018, 11:23 by Muhammad Riaz, Sarah Lewis, Tim Coleman, Paul Aveyard, Robert West, Felix Naughton, Michael Ussher
AIMS: To examine the ability of different common measures of cigarette dependence to predict smoking cessation during pregnancy. DESIGN: Secondary analysis of data from a parallel-group randomized controlled trial of physical activity for smoking cessation. The outcomes were biochemically validated smoking abstinence at 4 weeks post-quit and end-of-pregnancy. SETTING: Women identified as smokers in antenatal clinics in 13 hospital trusts predominantly in southern England, who were recruited to a smoking cessation trial. PARTICIPANTS: Of 789 pregnant smokers recruited, 784 were included in the analysis. MEASUREMENTS: Using random-effect logistic regression models, we analysed the effects of baseline measures of cigarette dependence, including numbers of cigarettes smoked daily, Fagerström Test of Cigarette Dependence (FTCD) score, the two FTCD subscales of Heaviness of Smoking Index (HSI) and non-Heaviness of Smoking Index (non-HSI), expired carbon monoxide (CO) level and urges to smoke (strength and frequency) on smoking cessation. Associations were adjusted for significant socio-demographic/health behaviour predictors and trial variables, and area under the receiver operating characteristic (ROC) curve was used to determine the predictive ability of the model for each measure of dependence. FINDINGS: All the dependence variables predicted abstinence at 4 weeks and end-of-pregnancy. At 4 weeks, the adjusted odds ratio (OR) (95% confidence interval) for a unit standard deviation increase in FTCD was 0.59 (0.47-0.74), expired CO = 0.54 (0.41-0.71), number of cigarettes smoked per day 0.65 (0.51-0.84) and frequency of urges to smoke 0.79 (0.63-0.98); at end-of-pregnancy they were: 0.60 (0.45-0.81), 0.55 (0.37-0.80), 0.70 (0.49-0.98) and 0.69 (0.51-0.94), respectively. HSI and non-HSI exhibited similar results to the full FTCD. CONCLUSIONS: Four common measures of dependence, including number of cigarettes smoked per day, scores for Fagerström Test of Cigarette Dependence and frequency of urges and level of expired CO, all predicted smoking abstinence in the short term during pregnancy and at end-of-pregnancy with very similar predictive validity.
This project was funded by the National Institute for Health Research Health Technology Assessment Programme (project number 07.01.14). The open access publication has been funded by Cancer Research UK.
CitationAddiction, 2016, 111 (9), pp. 1656-1665
Author affiliation/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences
VersionVoR (Version of Record)
PublisherWiley, Society for the Study of Addiction
Cigarette dependence measuresphysical activitypredictorspregnancyrandomised control trailsecondary analysissmoking cessationAdultBreath TestsCarbon MonoxideEnglandExerciseFemaleHumansLogistic ModelsOdds RatioPregnancyPregnancy ComplicationsPrognosisROC CurveRandomized Controlled Trials as TopicSeverity of Illness IndexSmoking CessationSurveys and QuestionnairesTobacco Use DisorderYoung Adult