Evaluating the effectiveness of mailout smoking cessation support: A systematic review and meta-analysis

One of the main barriers to smoking cessation support is accessibility. Mailout supports can potentially mitigate access barriers, but their effectiveness has not been explored. The aim of this review is to evaluate the effectiveness of mailout smoking cessation support.

A systematic review was conducted using studies retrieved from six databases, from inception to May 2024. The methodological qualities were assessed using the Joanna Briggs Institute Critical Appraisal tools. Meta-analysis was performed using random-effects model to estimate pooled effects. Heterogeneity was evaluated using the Higgins' I² test. Publication bias was assessed through a funnel plot and Egger's regression test.

A total of 1918 citations were screened, resulting in the inclusion of 12 RCTs. Mailout support significantly improved the odds of smoking cessation at six to twelve months (OR = 1.43, 95 % CI: 1.29, 1.59). Interventions that included nicotine replacement therapies (NRT) were associated with higher odds of smoking cessation (OR = 1.61, 95 % CI: 1.38, 1.87) compared to behavioural interventions alone (OR = 1.28, 95 % CI: 1.11, 1.48). Interventions lasting longer than 12 weeks resulted in higher odds of smoking cessation (OR = 1.57, 95 % CI 1.29, 1.59) compared to interventions lasting 8 to 12 weeks (OR = 1.52, 95 % CI 1.29, 1.80) and less than 8 weeks (OR = 1.40, 95 % CI 1.10, 1.77).

Mailout smoking cessation support improves quitting, especially when interventions include NRT and delivered for longer than 12 weeks. While further research is needed to refine implementation strategies, mailout smoking cessation supports are effective and have potential to reduce access barriers.