Research trial call for pregnant smokers

Mar 4 2009

Mums-to-be across the East Midlands are being invited to take part in research that aims to establish whether nicotine patches are safe and effective for pregnant smokers.

Around 750 women have already signed up for the £1.3 million Smoking, Nicotine and Pregnancy (SNAP) trial but a further 300 participants are being sought by the researchers in The University of Nottingham's Division of Primary Care.

The call follows the recent launch of a powerful Government campaign to raise awareness of the dangers of women smoking in pregnancy and the extremely serious health risks it can pose to both the mother and her unborn child.

Around 30 per cent of pregnant women smoke and researchers say it can cause significant health problems for the unborn child. It accounts for around 4,000 fetal deaths every year, including miscarriages, and can contribute to premature births, low birth weight, cot death and asthma. It is also associated with problems later in childhood, including attention deficit and learning difficulties.

Smoking brings the fetus into contact not just with nicotine but with a long list of other harmful chemicals. Expert consensus is that using nicotine replacement therapy (NRT), such as patches, is probably safer than smoking. However, while NRT can double a non-pregnant smoker's chances of giving up, pregnant women metabolise nicotine a lot faster so it cannot be assumed that NRT will even work for them. The University of Nottingham trial will aim to establish empirically that they are safe and effective.

Funded by the National Institute for Health Research's Health Technology Assessment Programme, the trial is targeting women who attend hospital for antenatal ultrasound scans at between 12 and 24 weeks pregnant. If they agree to take part, they receive either nicotine or placebo patches. In addition, they are also offered support and advice on issues such as how to deal with cravings and strategies to avoid smoking.

The study will also focus on the effect of patches on the behaviour and development of the child and the trial participants will be followed until their children are two years old when infants' cognitive development and respiratory symptoms will be compared.

Leading the study, Dr Tim Coleman in the Division of Primary Care, said: "It's fantastic that so many women have chosen to sign up for the study and reflects the massive commitment by the research team. Women who enrol in the trial receive effective behavioural counselling to help them to stop smoking, whilst also helping to answer important clinical questions about the effectiveness of NRT for smoking cessation in pregnancy."

Research midwives are recruiting women to the SNAP trial at Nottingham City Hospital, Queens Medical Research Centre, King's Mill Hospital in Mansfield, University Hospital of North Staffordshire in Stoke-on-Trent, Leighton Hospital in Crewe and Macclesfield District General.

The Department of Health launched its new smokefree campaign aimed at pregnant women earlier this month. Supported by women's health specialist Dr Miriam Stoppard, it seems to encourage public support for pregnant women in their attempts to quit and to boost the number of women accessing the specialist pregnancy NHS Stop Smoking Services.

The new campaign highlights the fact that every cigarette smoked restricts the essential oxygen supply to an unborn baby, forcing their tiny heart to beat harder every time a pregnant woman smokes. It aims to reinforce the message that quitting - no matter how far along the pregnancy is - will have an immediate beneficial effect on the woman and her baby.

The NHS Pregnancy Smoking Helpline - 0800 169 9 169 - offers a free and friendly service that provides practical advice about stopping smoking.

Pregnant women interested in participating in the SNAP trial can contact the Trial Office on 0115 823 1899 or email [email protected] for more information.

http://www.nottingham.ac.uk/