***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : To evaluate the effectiveness in helping pregnant women stop smoking of two interventions ( Pro-Change for a healthy pregnancy ) based on the transtheoretical model of behaviour change ( TTM ) compared to current st and ard care . Design : Cluster r and omised trial . Setting : Antenatal clinics in West Midl and s , UK general practice s. Participants : 918 pregnant smokers Interventions : 100 general practice s were r and omised into the three trial arms . Midwives in these practice s delivered three interventions : A ( st and ard care ) , B ( TTM based self help manuals ) , and C ( TTM based self help manuals plus sessions with an interactive computer program giving individualised smoking cessation advice ) . Main outcome measures : Biochemically confirmed smoking cessation for 10 weeks previously , and point prevalence abstinence , both measured at 30 weeks of pregnancy and 10 days after delivery . Results : There were small differences between the TTM arms . Combining the two arms , the odds ratios at 30 weeks were 2.09 ( 95 % confidence interval ( CI ) 0.90 to 4.85 ) for 10 week sustained abstinence and 2.92 ( 95 % CI 1.42 to 6.03 ) for point prevalence abstinence relative to controls . At 10 days after delivery , the odds ratios were 2.81 ( 95 % CI 1.11 to 7.13 ) and 1.85 ( 95 % CI 1.00 to 3.41 ) for 10 week and point prevalence abstinence respectively . Conclusions : While there is a small borderline significant increase in quitting in the combined intervention arms compared with the controls , the effect of the intervention is small . At 30 weeks gestation and at 10 days postnatal , only about 3 % of the intervention groups achieved sustained cessation , with numbers needed to treat of 67 ( 30 weeks of gestation ) and 53 ( 10 weeks postnatal ) for one additional woman to achieve sustained confirmed cessation . Given also that the intervention was re source intensive , it is of doubtful benefit Background Behavioural support for smoking cessation in pregnancy can be effective ; however , many pregnant women face barriers to seeking support to stop smoking . Some digital interventions have been found to be effective for smoking cessation in the general population and may be effective for supporting cessation in pregnancy due to their flexibility and the potential for personalisation . To date , there is limited evidence of the effectiveness of digital interventions for smoking cessation in pregnancy . This review aims to assess the following : ( 1 ) whether digital interventions are effective at promoting smoking cessation among pregnant women ; ( 2 ) which behaviour change techniques ( BCTs ) or combinations of BCTs are associated with the effectiveness of digital interventions for smoking cessation in pregnancy ; and ( 3 ) whether the number of BCTs used is associated with the effectiveness of digital interventions for smoking cessation in pregnancy . Methods This review will include digital interventions delivered largely through computer ( PC or laptop ) , video/DVD , mobile phone ( including smartphones ) or portable h and held device ( e.g. tablet , iPad ) and include websites , mobile or tablet applications and SMS text messages . Interventions must be r and omised or quasi-r and omised controlled trials aim ed at women who smoke in pregnancy , with smoking cessation as a measured outcome ( preferably the latest available point prevalence smoking status measure taken during pregnancy , biochemically verified if available ) . Electronic bibliographic data bases will be search ed to identify suitable studies indexed in the following : Academic Search Complete , ASSIA , CINAHL , The Cochrane Library , EMBASE , Medline , PsycINFO , Scopus , and Web of Science . The search strategy will include key words and data base-specific subject headings relating to ‘ pregnancy ’ and ‘ smoking ’ and synonyms for the terms ‘ digital ’ and ‘ r and omised controlled trial ’ . Where required and where possible , the first and second authors will independently code interventions and control groups for BCTs . If data allows , meta-analyses will be used to assess intervention effectiveness and the effectiveness of BCTs . Discussion This systematic review will provide a detailed synthesis of the effectiveness of current research using digital interventions for smoking cessation in pregnancy , to build on the evidence base and guide the development of future research in this area . Systematic review registration PROSPERO Abstract Aims To estimate the effectiveness of pregnancy smoking  cessation support delivered by short message service ( SMS ) text message and key parameters needed to plan a definitive trial . Design Multi‐centre , parallel‐group , single‐blinded , individual r and omized controlled trial . Setting Sixteen antenatal clinics in Engl and . Participants Four hundred and seven participants were r and omized to the intervention ( n = 203 ) or usual care ( n = 204 ) . Eligible women were < 25 weeks gestation , smoked at least one daily cigarette ( > 5 pre‐pregnancy ) , were able to receive and underst and English SMS texts and were not already using text‐based cessation support . Intervention All participants received a smoking cessation leaflet ; intervention participants also received a 12‐week programme of individually tailored , automated , interactive , self‐help smoking cessation text messages ( MiQuit ) . Outcome measurements Seven smoking outcomes , including vali date d continuous abstinence from 4 weeks post‐r and omization until 36 weeks gestation , design parameters for a future trial and cost‐per‐quitter . Findings Using the vali date d , continuous abstinence outcome , 5.4 % ( 11 of 203 ) of MiQuit participants were abstinent versus 2.0 % ( four of 204 ) of usual care participants [ odds ratio ( OR ) = 2.7 , 95 % confidence interval ( CI ) = 0.93–9.35 ] . The Bayes factor for this outcome was 2.23 . Completeness of follow‐up at 36 weeks gestation was similar in both groups ; provision of self‐report smoking data was 64 % ( MiQuit ) and 65 % ( usual care ) and abstinence validation rates were 56 % ( MiQuit ) and 61 % ( usual care ) . The incremental cost‐per‐quitter was £ 133.53 ( 95 % CI = –£395.78 to 843.62 ) . Conclusions There was some evidence , although not conclusive , that a text‐messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care This study examined smoking cessation and cigarette reduction of indigent inner city pregnant women ( n = 193 ) who completed one of three interventions :  a special videoprogram based on their perceptions of the effects of smoking during pregnancy , the American Lung Association 's “ Freedom From Smoking For You and Your Baby ” program , or the usual physician 's advice . Six percent of the women quit smoking , and 43 % reduced the number of cigarettes they smoked . There were no significant differences among the three groups for either the number who quit smoking or who reduced the number of cigarettes smoked INTRODUCTION Implementation of evidence -based interventions for smoking during pregnancy is challenging . We developed 2 highly replicable interventions for smoking during pregnancy : ( a ) a computer-delivered 5As-based brief intervention ( CD-5As ) and ( b ) a computer-assisted , simplified , and low-intensity contingency management ( CM-Lite ) . METHODS A sample of 110 primarily Black pregnant women reporting smoking in the past week were recruited from prenatal care clinics and r and omly assigned to CD-5As ( n = 26 ) , CM-Lite ( n = 28 ) , CD-5As plus CM-Lite ( n = 30 ) , or treatment as usual ( n = 26 ) . Self-report of smoking , urine cotinine , and breath CO were measured 10 weeks following r and omization . RESULTS Participants rated both interventions highly ( e.g. , 87.5 % of CD-5As participants reported increases in likelihood of quitting ) , but most CM-Lite participants did not initiate reinforcement sessions and did not show increased abstinence .  CD-5As led to increased abstinence as measured by cotinine ( 43.5 % cotinine negative vs. 17.4 % ; odds ratio [ OR ] = 10.1 , p = .02 ) but not for CO-confirmed 7-day point prevalence ( 30.4 % abstinent vs. 8.7 % ; OR = 5.7 , p = .06 ) . Collapsing across CM-Lite status , participants receiving the CD-5As intervention were more likely to talk to a doctor or nurse about their smoking ( 60.5 % vs. 30.8 % ; OR = 3.0 , p = .02 ) . CONCLUSIONS Low-intensity participant-initiated CM did not affect smoking in this sample , but the CD-5As intervention was successful in increasing abstinence during pregnancy . Further research should seek to replicate these results in larger and more diverse sample s. Should CD-5As continue to prove efficacious , it could greatly increase the proportion of pregnant smokers who receive an evidence -based brief intervention Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE To evaluate a web-based contingency management program ( CM ) and a phone-delivered cessation counseling program ( Smoking Cessation for Healthy Births [ SCHB ] ) with pregnant smokers in rural Appalachia who were ≤12 weeks gestation at enrollment . DESIGN Two group r and omized design . SETTING Home-based cessation programs in rural Appalachia Ohio and Kentucky . PARTICIPANTS A community sample of pregnant smokers ( N = 17 ) . METHODS Participants completed demographic and smoking-related question naires and were assigned to CM ( n = 7 ) or SCHB ( n = 10 ) conditions . Smoking status was assessed monthly using breath carbon monoxide and urinary cotinine . RESULTS For CM , two of seven ( 28.57 % ) of the participants achieved abstinence , and three of 10 ( 30 % ) of those enrolled in SCHB were abstinent by late in pregnancy . Participants in CM attained abstinence more rapidly than those in SCHB . However , those in SCHB experienced less relapse to smoking , and a greater percentage of these participants reduced their smoking by at least 50 % . CONCLUSION Based on this initial evaluation , the web-based CM and SCHB programs appeared to be feasible for use with rural pregnant smokers with acceptable program adherence for both approaches . Future research ers could explore combining these programs to capitalize on the strengths of each , for example , rapid smoking cessation based on CM incentives and better sustained cessation or reductions in smoking facilitated by the counseling support of SCHB Smoking during pregnancy is a plausible risk factor for childhood cancer , yet previous studies have yielded conflicting results , and few prospect i ve studies have been published . Data on maternal smoking were obtained from California birth certificates . We linked  California birth certificates ( births 2007 - 2011 ) with California Cancer Registry records for childhood cancer cases ( diagnosed January 2007-September 2013 ) that were ages 5 or younger at diagnosis ( N cases = 2,021 ) . Controls ( N = 40,356 ) were frequency-matched by birth year and r and omly selected from birth certificate records . We used unconditional logistic regression to obtain odds ratios ( OR ) and 95 % confidence intervals ( CI ) to assess the association between smoking during pregnancy and childhood cancer . We observed positive associations for gliomas ( OR = 1.8 , 95 % CI : 1.0 - 3.4 ) and retinoblastoma ( OR = 3.0 , 95 % CI : 1.4 - 6.6 ) , particularly bilateral retinoblastoma ( OR = 9.4 , 95 % CI 3.6 - 24.7 ) with maternal smoking in pregnancy . Maternal smoking during pregnancy may be a risk factor for retinoblastoma and certain types of childhood brain tumors INTRODUCTION There is a need for innovation in both the enrollment of pregnant smokers in  smoking cessation treatment programs  and in the types of treatments offered . The study tests whether an interactive and intensive text messaging program , Quit4baby , can promote smoking cessation for pregnant women already enrolled in a health text messaging program , Text4baby .  METHODS Between July 2015 and February 2016 , a total of 35,957 recruitment text messages  were sent to Text4baby subscribers . Eligible pregnant smokers were enrolled and r and omized to receive Text4baby ( control ) or Text4baby and Quit4baby ( intervention ; N=497 ) . Participants were surveyed at 1 month , 3 months , and 6 months post-enrollment , and saliva sample s were collected at 3 months for biochemical verification of smoking status . Data were collected from 2015 to 2016 and analyzed in 2016 . RESULTS Using an intention-to-treat analysis , 28.80 % of the intervention group and 15.79 % of the control group reported not smoking in the past 7 days at 1 month ( p<0 
    Output:
    
A meta-regression suggested that interventions using larger numbers of BCTs produced the greatest effects .
This paper highlights the potential for digital interventions to improve rates of smoking cessation in pregnancy