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Physician advice for smoking cessation.
The Cochrane Database of Systematic Reviews
|October 21, 2004
Summary
Physician advice for smoking cessation yields a small but significant increase in quitting rates. More intensive interventions show a marginal advantage over minimal advice, though mortality effects remain unproven.
Area of Science:
- Public Health
- Clinical Medicine
- Behavioral Science
Background:
- Healthcare professionals often advise patients to quit smoking.
- Advice can range from brief interventions to more intensive programs.
Purpose of the Study:
- Assess the effectiveness of physician advice in promoting smoking cessation.
- Compare minimal versus intensive physician interventions.
- Evaluate aids to smoking cessation advice and impact on mortality.
Main Methods:
- Systematic review of randomized trials of physician smoking cessation advice.
- Searches included Cochrane Tobacco Addiction Group register and CENTRAL up to March 2004.
- Abstinence assessed at least six months post-advice; meta-analysis used Mantel-Haenszel fixed effect model.
Main Results:
- 39 trials (over 31,000 smokers) analyzed; brief advice increased quitting odds (OR 1.74).
- Intensive advice showed a small advantage over minimal advice (OR 1.44).
- No significant difference in mortality observed in the single study assessing this outcome.
Conclusions:
- Simple physician advice has a small but significant effect on smoking cessation rates.
- Intensive interventions are marginally more effective than minimal ones.
- Additional maneuvers and aids show limited added benefit.