Do social support interventions ("buddy systems") aid smoking cessation? A review

To provide an overview of the role of social support in smoking cessation and to critically review evidence regarding the use of "buddy systems" (where smokers are specifically provided with someone to support them) to aid smoking cessation.

Studies were located by searching Medline and Psyclit using the key words "smoking", "smoking cessation", "social support", and "buddy". Additional studies were identified through reference lists. Only studies reported in English and published since 1980 were included.

Studies were selected on four criteria: publication in a peer reviewed journal; randomised controlled trial using smokers who wanted to stop; the use of a social support intervention, including a "buddy"; dependent variable of smoking abstinence. Most research in this area does not use a randomised design so only a small proportion of the originally identified studies were included.

In view of the diverse nature of the studies, a meta-analysis was not attempted. Ten studies were identified: nine were clinic based smoking trials, eight used a group format, and nine used buddies from among smokers' existing relationships. Support training varied from role play and rehearsal to a simple instruction to call each other regularly. Intervention and follow up periods varied between studies. Two studies showed a significant benefit of the intervention in the short term.

Research methodology in many cases was poor. The evidence would suggest that in the context of a smokers clinic the use of buddies may be of some benefit. There is a lack of evidence regarding the efficacy of the use of buddies in community interventions. This is an important area for future research.