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Smoking cessation

Evidence

This section contains a brief overview of the research carried out in this area. The evidence is divided into the settings listed here.

View overview

There are several interventions with proven clinical effectiveness and excellent cost effectiveness in increasing the rate of smoking cessation. These include nicotine replacement therapy (NRT), bupropion and varenicline, and providing psychological support in groups, face to face, or through telephone counselling. The effect sizes are usually small but the interventions are cheap and the health gains from stopping smoking are usually very large. As a result, the cost per quality adjusted life year gained is typically less than £1000 for a smoking cessation intervention compared with more than £10 000 for the average cost of life saving medical interventions such as coronary artery bypass surgery and medications to control blood pressure. 1

References

  1. West R. The clinical significance of ‘small’ effects of smoking cessation interventions. Addiction 2007;102:506-9.

Interventions to promote smoking cessation

View Methodology

Topics searched

We searched for studies on promoting smoking cessation in people of all ages.

We included studies with the following interventions:

  • Stop smoking groups, focused on counselling and education (including marketing of stop smoking services)
  • Individual counselling by a general practitioner or trained counsellor
  • Tobacco control policies (for example, tax, smoking ban)
  • Brief advice from a healthcare professional (for example, a letter from a doctor, advice from a nurse)
  • Incentives or competitions for participants (for example, “Quit and Win”)
  • Incentives or competitions for health professionals and staff
  • Education/educational materials targeting smokers
  • Education targeting health professionals or staff, or both
  • Telephone counselling
  • Exercise
  • Partner support or social support
  • Multiple component interventions (that is, any combination of the interventions listed)
  • Self help.

During critical appraisal, we excluded studies which had self report outcomes that were unvalidated by either another person or another outcome.

Dates and study types searched

We searched for systematic reviews published from 1990 until October 2006 and randomised controlled trials published from 2001 until October 2006.

Databases searched

We searched Medline, Embase, and the Cochrane Library for relevant studies. We also searched the Trip database, Health evidence.ca, Project Cork, and the WHO Health Evidence Network (HEN).

Search strategies

These are searches that have been conducted on Ovid Medline (http://gateway.ovid.com/). The other searches have been adapted from this one to accommodate the search engine of each specific database.

1. Psychotherapy, Group/

2. public policy/ or health policy/

3. (competition? or incentive? or prize? or reward$).ti,ab.

4. (motivational interview$ or brief intervention$ or brief treatment$).ti,ab.

5. exp Education, Continuing/

6. (telephone counselling or hotline or helpline or quitline).ti,ab.

7. Hotlines/

8. (support$ adj2 (family or partner$ or spous$ or friend$)).ti,ab.

9. (support adj1 social).ti,ab.

10. ((educat$ or pamphlet? or reading material? or brochure? or training) adj3 smoking$).ti,ab.

11. exp Exercise Movement Techniques/

12. (self-help or self help).ti,ab.

13. Self Care/

14. Self-Help Groups/

15. (psychotherapy or counselling).ti,ab.

16. Smoking/pc [Prevention & Control]

17. exp "Tobacco Use Cessation"/

18. (smoking adj2 cessation).ti,ab.

19. ((stop$ or quit$ or reduc$ or decreas$) adj1 smoking).ti,ab.

20. or/1-15

21. or/16-19

22. 20 and 21

Filter

The following filter was used to include only randomised controlled trials or systematic reviews:

  1. ("review" or "review academic" or "review tutorial").pt.
  2. (medline or medlars or embase).tw,sh
  3. (scisearch or psychinfo or psycinfo).tw,sh.
  4. (psychlit or psyclit).tw,sh.
  5. cinahl.tw,sh.
  6. ((hand adj2 search$) or (manual$ adj2 search$)).tw,sh.
  7. (electronic database$ or bibliographic database$ or computeri?ed database$ or online database$).tw,sh
  8. (pooling or pooled or mantel haenszel).tw,sh.
  9. (peto or dersimonian or der simonian or fixed effect).tw,sh.
  10. or/2-9 47239
  11. 1 and 10
  12. meta-analysis.pt.
  13. meta-analysis.sh.
  14. (meta-analys$ or meta analys$ or metaanalys$).tw,sh.
  15. (systematic$ adj5 review$).tw,sh.
  16. (systematic$ adj5 overview$).tw,sh.
  17. (quantitativ$ adj5 review$).tw,sh.
  18. (quantitativ$ adj5 overview$).tw,sh.
  19. (quantitativ$ adj5 synthesis$).tw,sh
  20. (methodologic$ adj5 review$).tw,sh.
  21. (methodologic$ adj5 overview$).tw,sh.
  22. (integrative research review$ or research integration).tw.
  23. or/12-22
  24. 11 or 23
  25. exp Randomized controlled trials/
  26. "randomized controlled trial".pt.
  27. "controlled clinical trial".pt.
  28. (random$ or placebo$).ti,ab,sh.
  29. ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$)).tw,sh.
  30. or/25-29
  31. (animals not humans).sh.
  32. 30 not 31