Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation
Lindsay F Stead1, Tim Lancaster
1Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. lindsay.stead@phc.ox.ac.uk.
The Cochrane Database of Systematic Reviews
|December 14, 2012
Summary
Intensified behavioral support significantly boosts smoking cessation success rates when combined with pharmacotherapy. Increasing support intensity by 10-25% improves quit rates, especially with at least four contact sessions.
Area of Science:
- Public Health
- Behavioral Science
- Pharmacology
Background:
- Smoking cessation pharmacotherapies are effective but quitting remains challenging.
- Higher levels of behavioral support may further enhance success rates.
Purpose of the Study:
- To evaluate the impact of increased behavioral support intensity on smoking cessation medication users.
- To assess differential effects based on pharmacotherapy type or support intensity.
Main Methods:
- Searched Cochrane Tobacco Addiction Group Register for trials on pharmacotherapy and behavioral support.
- Included randomized or quasi-randomized controlled trials with at least six months follow-up.
- Analyzed 38 trials (over 15,000 participants) using meta-analysis (Mantel-Haenszel fixed-effect model).
Main Results:
- More intensive behavioral support showed a small but significant benefit (RR 1.16, 95% CI 1.09 to 1.24) for smoking abstinence.
- Studies with at least four contact sessions or telephone counseling showed larger effects.
- No significant effects detected for nortriptyline or varenicline, due to limited evidence.
Conclusions:
- Behavioral support, in-person or via telephone, offers a small but significant benefit for smoking cessation with pharmacotherapy.
- Increased behavioral support may improve success rates by 10-25%.
- Greater benefits observed when contrasting no-contact controls with interventions providing at least four sessions.
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