Completed Pregnancy, Children & Inherited Conditions Lungs & Breathing

Double-blind, randomised, placebo-controlled trial of nicotine replacement therapy (NRT) in pregnancy - SNAP

Funder NIHR (part of DHSC)
Recipient organisation University of Nottingham Source-published name: The University of Nottingham
Funding £1.4M
Period Feb 2006 — May 2013

In plain English

AI plain-English summary

Around 4,000 foetal deaths in the UK each year are linked to mothers smoking during pregnancy. Despite this, the standard treatment for quitting—nicotine replacement therapy (NRT)—has never been tested in a definitive clinical trial for pregnant women. The problem is that doctors currently have no clear evidence on whether NRT actually works during pregnancy, or whether it might affect the child’s development later on. This trial will give pregnant smokers and their clinicians a straight answer: does NRT help them quit, and is it safe for their children at age two? If the results show NRT is effective and safe, it could change NHS guidance immediately, giving thousands of pregnant women a proven tool to stop smoking. If it does not work, the trial will prevent wasted effort and money on an ineffective treatment, and redirect resources toward other approaches. Either way, the findings will fill a critical gap in maternal healthcare that has persisted for decades.

View original technical description
Maternal smoking during pregnancy is a major public health problem, accounting for around 4,000 foetal deaths in the UK annually. It causes significant postnatal morbidity and mortality through low birth weight, pre-term birth, sudden infant death syndrome and asthma. Maximising the effectiveness of smoking cessation interventions for pregnant smokers is, therefore, important. Current best practice in non-pregnant smokers is to offer behavioural support and either nicotine replacement therapy (NRT) or bupropion. Bupropion is contraindicated in pregnancy, however, and although guidance to health professionals recommends that NRT can be used, the effectiveness of NRT in pregnancy has not been tested in definitive clinical trials. We, therefore, propose this study to determine: i) Whether NRT at conventional doses is effective and cost-effective for smoking cessation in pregnancy. ii) Whether NRT used in pregnancy has any appreciable effect on behavioural and developmental outcomes in subsequent children at two years.

Related Research

Grants with similar aims, by meaning.

Use of 'higher dose' nicotine replacement therapy (NRT) for smoking cessation in pregnancy: investigating the role of nicotine metabolism and treatment adherence
Using NRT for smoking reduction in pregnancy; exploration of novel cohort data and qualitative study
Does nicotine replacement therapy reduce detrimental fetal impacts of smoking in pregnancy? Exploratory analysis of novel ecological momentary assessments
Helping pregnant smokers quit: Multi-centre RCT of electronic cigarettes vs usual care.
Systematic review and meta-analysis investigating nicotine, cotinine and carbon monoxide exposures in people who both smoke and use nicotine replacement therapy

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