Background: Smoking is the most important modifiable risk factor for
adverse pregnancy outcome in the UK. New tools are needed to improve smoking
cessation advice. The aim was to investigate a point-of-care urine test for smoking,
to provide feedback to women, to improve awareness about the effects of smoking
during pregnancy and to relate the test results to pregnancy outcome.
Methods: A cross-sectional randomized controlled trial involving 856
pregnant women. All intervention patients were interviewed at their initial visit and
tested for smoking. The test provided visual and numerical feedback. Smokers were
followed up and retested at subsequent visits. The control group received
anti-smoking counselling as part of routine care, but their smoking was monitored
using the test. Both groups were interviewed and retested at 36 weeks' gestation.
Results: Self-reported cigarette consumption fell significantly
(P < 0.001) in the intervention group, with 16.2% giving up
and 33.3% significantly reducing their cigarette consumption. There was a significant
fall in test results from 'booking' to 36 weeks' gestation (P <
0.0001). In the control group, only 8% reported stopping and 23% reducing their
cigarette consumption. Combined smoking test results at 36 weeks correlated
significantly with birth weight (P = 0.006) and body length
(P = 0.011).
Conclusions: Point-of-care testing and feedback coupled with counselling
can significantly reduce smoking during pregnancy and increase birthweight.
