The effectiveness of cognitive behavioral therapy for smoking cessation: A systematic review and meta-analysis

Cognitive Behavioral Therapy (CBT) is a commonly used intervention for smoking cessation. This PROSPERO-registered systematic review and meta-analysis (CRD42024581823) evaluated the long-term effectiveness of CBT in achieving abstinence for six months or longer. Sixteen randomized controlled trials (RCTs) involving 2,531 adults were included. Studies comparing CBT to minimal care and published in English or Korean were selected; those focusing on Acceptance and Commitment Therapy (ACT) or mindfulness were excluded. Results indicate that CBT significantly improves long-term cessation rates. Subgroup analyses showed that both CBT alone and CBT with pharmacotherapy were effective compared with minimal care. In particular, CBT demonstrated greater effectiveness among patients with smoking-related conditions such as COPD and cardiovascular disease. Risk of bias was generally rated as "some concerns," and the certainty of evidence was moderate. These findings support CBT's clinical utility, especially when integrated with pharmacological treatments or tailored to high-risk populations.