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Interventions for pregnant women who use tobacco and other substances: a systematic review protocol
  1. Melissa A Jackson1,2,
  2. Amanda L Baker1,
  3. Kristen L McCarter1,
  4. Amanda L Brown1,2,
  5. Gillian S Gould1,
  6. Adrian J Dunlop1,2,3
  1. 1 School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
  2. 2 Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
  3. 3 Drug & Alcohol Clinical Research & Improvement Network, Sydney, New South Wales, Australia
  1. Correspondence to Melissa A Jackson; Mel.Jackson{at}


Introduction The prevalence of tobacco smoking in pregnancy remains elevated in some disadvantaged populations of women. One group is those who use alcohol and/or other psychoactive substances during pregnancy, with tobacco use prevalence estimates ranging from 71% to 95%. Although effective evidence-based cessation treatments exist, few women with co-occurring substance use problems successfully stop smoking during pregnancy. There is limited information about treatments that specifically target this group and a summary of the available research is required to assist and enhance the development of innovative cessation interventions. This article describes a protocol for a comprehensive review of studies that have trialled behavioural and/or pharmacological tobacco cessation interventions in populations of pregnant women who are nicotine dependent and use alcohol and/or other psychoactive substances.

Methods and analysis The review will undertake literature searches in MEDLINE, PsycINFO, CINAHL, EMBASE and ProQuest databases, as well as the grey literature. Studies of any design methodology will be included if they describe changes to tobacco smoking behaviours in quantitative terms. No restriction on year of publication or published language will apply. Participants include pregnant women of any age, who smoke tobacco, who are seeking or having treatment, or in post-treatment recovery for the use of psychoactive substances. Interventions are any psychological, behavioural or pharmacological treatments used to treat tobacco use. Outcome measures are any that quantitatively report abstinence or reductions in participant tobacco consumption. Key details and tobacco-related outcomes from included studies will be extracted and tabulated before being narratively synthesised. The systematic review protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines.

Ethics and dissemination Ethics approval is not required. Findings will be disseminated via peer-reviewed literature, conference presentations, media and social media.

PROSPERO registration number CRD42018108777

  • smoking cessation
  • pregnancy
  • tobacco use disorder
  • substance use disorder
  • disadvantaged populations

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Twitter @MelJackson_1, @GillianSGould

  • Contributors MJ is the lead and the guarantor of this review. MJ and ABa conceptualised the review and drafted the manuscript. KM, GG, ABa, ABr and AD provided critical input and were involved in revising the protocol. MJ developed the search strategy included in the protocol. All authors approved the final version of the manuscript and accepted accountability for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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