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Abstract：
To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy.
Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest).
\"Counseling\", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child\'s development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression.
Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.
Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest).
\"Counseling\", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child\'s development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression.
Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.
摘要：
为孕期戒烟管理提供最新的循证指南。
国际文献系统综述。我们确定了2003年1月至2019年4月在CochranePubMed上发表的论文，和具有预定义关键字的Embase数据库。所有以法语和英语发表的与重点领域相关的报告都被纳入，并根据从1（最高）到4（最低）的证据水平进行分类。这些建议的强度是根据《最高自治条例》分类的，法国（从A，最高为C，最低)。
\"咨询\",涉及全球所有类型的非药物干预措施，对戒烟有一定的好处，出生体重和早产。适度的体力活动对戒烟没有显着影响。通过测量呼出的空气一氧化碳浓度来系统地使用反馈不会影响戒烟，但可以用于建立治疗联盟。建议使用自助干预措施和健康教育来帮助怀孕的吸烟者戒烟。尼古丁替代疗法（NRT）的处方可以提供给任何在没有药物的情况下戒烟失败的孕妇。该处方可以由保健专业人员在怀孕早期照顾孕妇。没有科学证据可以向怀孕的吸烟者提出戒烟的电子烟;建议提供相同的建议，并使用已经评估过的方法。怀孕期间使用水管（shisha/narghile）与胎儿生长减少有关。建议在怀孕期间不要使用水管。吸烟者可以母乳喂养，但很少由他们发起。虽然它对孩子的发展的好处没有证明到目前为止，母乳喂养允许母亲减少或停止吸烟。产后复发的风险很高（1年时高达82％）。与产后禁欲相关的主要因素是母乳喂养，家里没有吸烟者，没有产后抑郁症的症状。
在法国，每年有超过10万名妇女和她们的孩子在怀孕期间吸烟。这是一个重大的公共卫生负担。应动员卫生保健专业人员减少甚至根除这种疾病。
国际文献系统综述。我们确定了2003年1月至2019年4月在CochranePubMed上发表的论文，和具有预定义关键字的Embase数据库。所有以法语和英语发表的与重点领域相关的报告都被纳入，并根据从1（最高）到4（最低）的证据水平进行分类。这些建议的强度是根据《最高自治条例》分类的，法国（从A，最高为C，最低)。
\"咨询\",涉及全球所有类型的非药物干预措施，对戒烟有一定的好处，出生体重和早产。适度的体力活动对戒烟没有显着影响。通过测量呼出的空气一氧化碳浓度来系统地使用反馈不会影响戒烟，但可以用于建立治疗联盟。建议使用自助干预措施和健康教育来帮助怀孕的吸烟者戒烟。尼古丁替代疗法（NRT）的处方可以提供给任何在没有药物的情况下戒烟失败的孕妇。该处方可以由保健专业人员在怀孕早期照顾孕妇。没有科学证据可以向怀孕的吸烟者提出戒烟的电子烟;建议提供相同的建议，并使用已经评估过的方法。怀孕期间使用水管（shisha/narghile）与胎儿生长减少有关。建议在怀孕期间不要使用水管。吸烟者可以母乳喂养，但很少由他们发起。虽然它对孩子的发展的好处没有证明到目前为止，母乳喂养允许母亲减少或停止吸烟。产后复发的风险很高（1年时高达82％）。与产后禁欲相关的主要因素是母乳喂养，家里没有吸烟者，没有产后抑郁症的症状。
在法国，每年有超过10万名妇女和她们的孩子在怀孕期间吸烟。这是一个重大的公共卫生负担。应动员卫生保健专业人员减少甚至根除这种疾病。
