Evaluations of clinical tobacco cessation interventions in Arab populations: A systematic review

Tobacco smoking is prevalent among Arab smokers. Interventions to support smoking cessation may differ in effectiveness in this population from Western populations usually studied. This review assessed evidence of effectiveness of clinical smoking interventions in Arab smokers.

A systematic search for comparative trials evaluating tobacco cessation interventions in Arab populations was conducted in the MEDLINE, EMBASE, PyschINFO, CINHAL and Web of Science databases. Behavioural, pharmacological and combined interventions were included. Reference lists of included studies were hand searched. The outcome measure was self- reported tobacco abstinence at the final follow-up, with biochemical verification where available. Assessment of evidence for effectiveness was undertaken using Bayes Factors.

A total of 659 titles and abstracts were identified. Five studies met the inclusion criteria. Four of these were randomized controlled trials and one was a non-randomized comparative trial. Differences between study features precluded meaningful aggregation for a meta-analysis. The four randomized trials all yielded Bayes Factors <1, suggesting no effect of the intervention compared with the control condition. The non-randomized trial, conducted in tuberculosis clinics in Sudan, yielded an extremely high Bayes Factor (>1000), supporting the hypothesis of effectiveness; however, the study was judged to have a high risk of bias.

As yet, there is no convincing direct evidence that clinical smoking cessation interventions, which are found to be effective in Western populations, are also effective for Arab smokers. There is an urgent need for high quality randomized trials evaluating interventions in this population.