Behavioural interventions for smoking cessation: an overview and network meta-analysis
Jamie Hartmann-Boyce1, Jonathan Livingstone-Banks1, José M Ordóñez-Mena1
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
The Cochrane Database of Systematic Reviews
|January 7, 2021
Summary
Behavioral interventions for smoking cessation, including counseling and financial incentives, significantly increase quit rates. Effectiveness varies by intervention characteristics, but no increased harms were observed.
Area of Science:
- Public Health
- Behavioral Science
- Evidence Synthesis
Background:
- Smoking remains a primary global cause of disease and mortality.
- Quitting smoking can mitigate substantial health damage.
- Behavioral interventions are widely used for smoking cessation, but their content and effectiveness vary.
Purpose of the Study:
- To synthesize evidence on behavioral interventions for smoking cessation from Cochrane Reviews.
- To conduct a network meta-analysis to assess the influence of intervention components (delivery, provider, nature, intensity) on smoking abstinence.
- To examine the impact of population, setting, and pharmacotherapy on intervention effectiveness and summarize economic evaluations.
Main Methods:
- A Cochrane Overview of Reviews identified relevant Cochrane Reviews of behavioral interventions.
- A Bayesian component network meta-analysis (CNMA) synthesized data from 312 randomized controlled trials (250,563 participants).
- Component network meta-regression (CNMR) evaluated factors influencing intervention effects; GRADE criteria assessed evidence certainty.
Main Results:
- Behavioral interventions increase smoking cessation rates; effectiveness depends on intervention characteristics.
- High-certainty evidence supports counseling (OR 1.44) and guaranteed financial incentives (OR 1.46) for smoking cessation.
- Moderate-certainty evidence suggests benefits for text message delivery, individual tailoring, and motivational content; no increased harms were observed.
Conclusions:
- Behavioral support effectively increases long-term smoking cessation rates without evidence of harm.
- Counseling and guaranteed financial incentives demonstrate the strongest evidence of benefit.
- Further research is needed for tailoring, specific delivery modes, and motivational content; cost-effectiveness varies.
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