{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T13:46:41Z","timestamp":1776433601468,"version":"3.51.2"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2010778"],"award-info":[{"award-number":["2010778"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["273366"],"award-info":[{"award-number":["273366"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>As clinical trial evidence on the effectiveness of smoking cessation pharmacotherapies during pregnancy is inconclusive, we conducted a large cohort study examining their effectiveness and comparative effectiveness during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population\u2010based cohort study. We used propensity score matching and conditional Poisson regression to compare pharmacotherapy\u2010exposed with unexposed pregnancies, and to compare varenicline\u2010exposed with nicotine replacement therapy (NRT) \u2010exposed pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Birth records (2005\u20132020) from New South Wales (NSW) Australia, New Zealand (NZ) and Norway\/Sweden linked to pharmacotherapy dispensing records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants\/cases<\/jats:title>\n                    <jats:p>Women with a birth record indicating smoking in early pregnancy [during first 20\u2009weeks' gestation (NSW), at lead maternity registration (NZ) or during the first trimester (Norway\/Sweden)]. Participants were dispensed prescription NRT, varenicline or bupropion in the first 18\u2009weeks of gestation (NSW, Norway\/Sweden) or between the first antenatal visit and childbirth (NZ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>We defined smoking cessation as not smoking after gestational week 20 (NSW), at gestational week 32\u201336 (Norway\/Sweden) and at two weeks postpartum (NZ), identified via self\u2010report and documented in the birth record.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Our NRT analyses included 623, 7074 and 70 exposed and 6026, 68\u2009161 and 700 propensity\u2010score\u2010matched unexposed pregnancies from NSW, NZ and Norway\/Sweden, respectively. The associations between NRT and smoking cessation were mixed but tended toward reduced cessation compared with no pharmacotherapy. In NSW, NRT was associated with a reduction in cessation [relative risk (RR) = 0.68, 95% confidence interval (CI) = 0.48\u20130.97], while in NZ, the effect was smaller (RR = 0.93, 95% CI = 0.89\u20130.98) but inconclusive in Norway\/Sweden (RR = 0.91, 95% CI = 0.61\u20131.35). Smoking cessation was also equally or less common among varenicline\u2010exposed pregnancies (NSW: 308 exposed vs 3077 matched unexposed, RR = 0.89, 95% CI = 0.72\u20131.09, Norway\/Sweden: 196 exposed vs 1960 matched unexposed, RR = 0.49, 95% CI = 0.34\u20130.70). Our comparison of varenicline\u2010exposed with NRT\u2010exposed pregnancies indicated increased smoking cessation among varenicline\u2010exposed pregnancies (NSW: 108 vs 154 exposed, RR = 1.91, 95% CI = 1.10\u20133.22). There were too few bupropion\u2010exposed pregnancies to support interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Varenicline appears to be more effective at smoking cessation than nicotine replacement therapy during pregnancy. The uncertainty about the real\u2010world effectiveness of nicotine replacement therapy and bupropion remains as this study's analyses were impacted by non\u2010adherence and biased by unmeasured confounding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70290","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:45:13Z","timestamp":1766393113000},"page":"1112-1127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of smoking cessation pharmacotherapies during pregnancy: A multi\u2010national population\u2010based study"],"prefix":"10.1111","volume":"121","author":[{"given":"Annelies L.","family":"Robijn","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine and Health University of New South Wales (UNSW)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Donald","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Dunedin School of Medicine University of Otago \u2013 \u014ct\u0101kou Whakaihu Waka  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline M.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Chronic Diseases &amp; Centre for Fertility and Health Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duong T.","family":"Tran","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine and Health University of New South Wales (UNSW)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn E.","family":"Cesta","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Furu","sequence":"additional","affiliation":[{"name":"Department of Chronic Diseases &amp; Centre for Fertility and Health Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianne","family":"Parkin","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Dunedin School of Medicine University of Otago \u2013 \u014ct\u0101kou Whakaihu Waka  Dunedin New Zealand"},{"name":"New Zealand Pharmacovigilance Centre, Division of Health Sciences University of Otago \u2013 \u014ct\u0101kou Whakaihu Waka  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sallie\u2010Anne","family":"Pearson","sequence":"additional","affiliation":[{"name":"Medicines Intelligence Research Program, School of Population Health, Faculty of Medicine and Health University of New South Wales (UNSW)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Reutfors","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helga","family":"Zoega","sequence":"additional","affiliation":[{"name":"Centre of Public Health Sciences, Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Zwar","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences &amp; Medicine Bond University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6563-8804","authenticated-orcid":false,"given":"Alys","family":"Havard","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre, Faculty of Medicine and Health University of New South Wales (UNSW)  Sydney New South Wales Australia"},{"name":"Medicines Intelligence Research Program, School of Population Health, Faculty of Medicine and Health University of New South Wales (UNSW)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.1.136"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2016-207376"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.057"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/154.4.322"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntw188"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-10-24"},{"key":"e_1_2_9_8_1","unstructured":"CurtinSC MathewsTJ.Smoking prevalence and cessation before and during pregnancy: data from the birth certificate 2014. 2016."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018746"},{"key":"e_1_2_9_10_1","unstructured":"Australian Institute of Health and Welfare.National perinatal data collection annual update 2021 \u2010 data tables. 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