Tools- of Changes

Preventing Smoking Relapse in Postpartum Women

This is a priced article covering a systematic review and meta-analysis that focused on 11 studies from 10 Randomized Controlled Trials involving 3,365 participants. The article compares the efficacy of cognitive behavioral therapy (CBT) and motivational interviewing (MI).

This systematic review and meta-analysis was conducted up to January 1, 2025 and the meta-analysis focused on 12 Randomized Controlled Trials with a total of 2,782 participants. Family-based behavioral interventions significantly increased abstinence in low-income households where both parents smoked and pharmacotherapy was included. Interventions that incorporated behavioral counseling with nicotine replacement therapy and implemented with a long-term follow-up tended to be more effective. CBT-MI and MI appear promising in improving the maintenance of smoking abstinence within 12 months postpartum, though further research is needed to enhance long-term abstinence.

Comparisons with standard care revealed that CBT [relative risk (RR) = 1.03; 95% CI: 0.86, 1.19], CBT-MI (RR = 1.41; 95% CI: 0.87, 2.27), and MI (RR = 1.06; 95% CI: 0.90, 1.24) failed to maintain smoking abstinence at 12 months postpartum. The absolute differences were imprecise, with wide CIs encompassing both potential increases and decreases in smoking abstinence: 7 more per 1000 (95% CI: -31, 43) for CBT, 92 more per 1000 (95% CI: -29, 284) for CBT-MI, and 13 more per 1000 (95% CI: -22, 54) for MI, all with moderate certainty evidence. Subgroup analyses for follow-up periods of <12 months indicated that CBT-MI (RR = 1.67; 95% CI: 1.08, 2.60) and MI (RR = 1.16; 95% CI: 1.01, 1.33) may improve the maintenance of smoking abstinence over the short term.

Published in June 2025