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Combined pharmacotherapy and behavioural interventions for smoking cessation
Lindsay F Stead1, Priya Koilpillai, Thomas R Fanshawe
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK, OX2 6GG.
The Cochrane Database of Systematic Reviews
|March 25, 2016
Summary
Combining pharmacotherapy (medication) and behavioral support significantly increases smoking cessation success rates compared to minimal intervention. This combined approach is effective across various settings, particularly in healthcare environments.
Area of Science:
- Public Health
- Addiction Medicine
- Behavioral Science
Background:
- Both behavioral support and pharmacotherapies are established smoking cessation aids.
- Combining these approaches is recommended, but effect sizes across different contexts are unclear.
Purpose of the Study:
- To assess the effectiveness of combined behavioral support and pharmacotherapy for smoking cessation.
- To identify factors influencing treatment efficacy, including setting, intervention characteristics, population, and treatment uptake.
Main Methods:
- Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
- Searched Cochrane Tobacco Addiction Group register for studies on pharmacotherapies (NRT, bupropion, varenicline).
- Included trials with at least six months follow-up, excluding those solely on pregnant women or adolescents.
Main Results:
- 52 studies (19,488 participants) showed high-quality evidence for combined treatment efficacy (RR 1.83).
- Combined therapy was more effective in healthcare settings (RR 1.97) than community settings (RR 1.53).
- No significant differences in effect were found based on motivation, provider, session details, or uptake.
Conclusions:
- Combined pharmacotherapy and behavioral support significantly improve smoking cessation outcomes.
- Recruitment setting is a key factor influencing treatment effectiveness.
- No evidence suggests more intensive behavioral support yields larger treatment effects.
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