Nicotine Replacement Treatment for Pregnant Smokers - 1
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|ClinicalTrials.gov Identifier: NCT00115687|
Recruitment Status : Terminated (Efficacy rates did not show large enough differences between treatments)
First Posted : June 24, 2005
Last Update Posted : January 12, 2017
Smoking during pregnancy is an important modifiable cause of poor pregnancy outcomes. Even with augmented behavioral interventions, smoking cessation rates in pregnancy trials rarely exceed 20%. These low quit rates may be due to inadequate treatment of the physical dependence on nicotine. Indeed, medications, which may help to reduce nicotine withdrawal symptoms, are a first-line treatment for smoking treatment in non-pregnant smokers. However, little information is available on the safety or efficacy of medications to treat pregnant smokers.
The purpose of this trial is to evaluate the safety and effectiveness of 2 mg nicotine gum in promoting smoking cessation during pregnancy. The design is a randomized, placebo controlled trial where subjects are randomized to nicotine gum (6 weeks ad libitum use followed by a 6 week taper) or a matching placebo. Women who are doing well at the end of the trial will also be offered gum post-partum for relapse prevention.
|Condition or disease||Intervention/treatment||Phase|
|Tobacco Use Disorder||Drug: placebo Drug: 2 mg nicotine polacrilex||Phase 2|
This proposal will examine the utility of one first-line medication, nicotine gum, as an aid to smoking cessation during pregnancy.
The specific aims are:
- (1) To compare smoking cessation rates and smoking reduction among pregnant smokers who are randomized to receive nicotine gum (2 mg dose) or a matching placebo;
- (2) To compare nicotine gum versus placebo on surrogate measures of maternal and fetal safety (i.e., overall nicotine and tobacco exposure at 6 weeks after the quit date and at 32-34 weeks gestation) and birth weight at the time of delivery;
- (3) To examine which subjects benefit the most from the use of nicotine gum for smoking cessation during pregnancy.
Subjects will be recruited from prenatal clinics that serve primarily a low-income, minority population. Two hundred sixty-eight pregnant smokers will be randomly assigned to receive smoking cessation behavioral counseling and either a 6-week course of mint flavored placebo or nicotine gum, followed by 6 weeks of decreasing doses. Maternal blood for genotyping will be obtained at study entry. Primary outcome measures will be 7-day point prevalence of cigarette abstinence, number of cigarettes smoked per day, urinary cotinine concentrations, and measures of tobacco exposure (i.e., carbon monoxide in exhaled air and urine anabasine and anatabine) at 6 weeks after the quit date and at 32-34 weeks gestation, and infant birth weight. We hypothesize that:
- (1) Pregnant smokers who are randomized to nicotine gum will have double the quit rates and will reduce their smoking to a greater degree than subjects randomized to placebo;
- (2) Nicotine gum compared to placebo will reduce maternal levels of tobacco-exposure markers and increase birth weights in the offspring;
- (3) The odds of cigarette abstinence will be increased primarily in subjects who smoke at least 15 cigarettes per day.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||250 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Double (Participant, Care Provider)|
|Official Title:||Nicotine Replacement Treatment for Pregnant Smokers|
|Study Start Date :||June 2002|
|Actual Primary Completion Date :||April 2007|
|Actual Study Completion Date :||April 2007|
Placebo Comparator: A
2 mg nicotine gum
|Drug: 2 mg nicotine polacrilex|
- Biochemically validated quit rates [ Time Frame: 6 weeks after treatment, end of pregnancy ]
- tobacco exposure measurements [ Time Frame: 6 weeks after treatment, end of pregnancy ]
- birth weight [ Time Frame: time of delivery ]
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00115687
|United States, Connecticut|
|University of Connecticut Health Center|
|Farmington, Connecticut, United States, 06030|
|Hartford, Connecticut, United States, 06106|
|The Hospital of Central Connecticut|
|New Britain, Connecticut, United States, 06050|
|United States, Massachusetts|
|Baystate Medical Center|
|Springfield, Massachusetts, United States, 01199|
|Principal Investigator:||Cheryl A Oncken, M.D.||UConn Health|