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Title: A randomised controlled trial to assess the effect of a physical activity intervention on smoking cessation, depression, and gestational weight, and to determine predictors of smoking cessation, among pregnant smokers trying to quit
Author: Riaz, Muhammad
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2017
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BACKGROUND: Smoking in pregnancy is one of the key preventable causes of morbidity among women and offspring, and is associated with adverse pregnancy and birth outcomes. Behavioural support is an effective intervention for smoking cessation in pregnancy and physical activity (PA) programmes may add to behavioural support. OBJECTIVE: This thesis used data from a rigorously conducted RCT (LEAP study) to examine the effect of a PA intervention during pregnancy on increasing PA levels, smoking cessation, depression, and gestational weight gain. It also conducted a comprehensive systematic review for identifying factors associated with smoking cessation and used the RCT data to investigate cigarette dependence related predictors of smoking cessation during pregnancy. METHODS: Between April 2009 and January 2014, 789 pregnant smokers aged 16-50 years, and having gestational age between 10 to 24 weeks, currently smoking at least one cigarette daily, and ready to quit smoking one week after enrolment, were recruited from 13 NHS hospitals in the South of England to a parallel group, RCT of PA intervention versus usual care. In the intention to treat analyses, 785 women (with 392 assigned to the PA group) were included. The intervention included 14 sessions of combining supervised treadmill exercise and PA consultations plus 6 weekly sessions of behavioural support for smoking cessation; the intervention started one week before the quit date. The primary outcome was bio-chemically validated continuous smoking abstinence from the quit date until end-of-pregnancy. Secondary outcomes included validated continuous abstinence at 4 weeks post-quit and self-reported abstinence at six months follow up after delivery, change in physical activity minutes during pregnancy, depression and gestational weight gain (GWG). STATISTICAL METHODS: Multiple logistic, mixed effect logistic, linear regression, and mixed effect linear models, ROC curve analyses, and Bland Altman’s analyses were sed to conduct the analyses. Sensitivity analyses were conducted to assess the influence of the assumption of missing data equals smoking and multiple imputation was used for assessing the influence of missing data in the outcomes of PA minutes, depression and GWG.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available