Efficacy of Yoga in Tobacco Cessation: A Systematic Review and Meta-Analysis

Tobacco consumption is a global epidemic with a high relapse rate. A complementary method like yoga, recognized for addressing psychological and behavioral aspects of addiction, was evaluated in this systematic review and metaanlaysis.

The objective was to comprehensively summarize the current evidence and evaluate the efficacy of yoga in tobacco cessation. This review was registered with PROSPERO (CRD42025643806). A systematic search across four databases identified randomized controlled trials (RCTs) in English up to September 2024. Eligible studies included adults (≥18 years) using any form of tobacco excluding vaping, randomized to yoga as monotherapy or adjunct therapy. The primary outcome was 7-day point prevalence abstinence (7PPA), while the secondary outcomes included quality of life, depression, anxiety, and mood states. Two reviewers independently extracted data and assessed quality using the Cochrane Risk of Bias (RoB2) tool. A meta-analysis was conducted for outcomes assessed in at least two studies.

Seven RCTs were included, with five suitable for meta-analysis. The pooled odds ratio for 7PPA at the end of treatment was 1.50 (95% confidence interval = 0.60 to 3.73), suggesting a positive but inconsistent effect. Considerable heterogeneity was observed (I2 = 65%, p = .07; τ2 = 0.7127), indicating substantial variability across studies. Heterogeneity (I2 = 65%) markedly reduced to 16% when high-risk trials were excluded in sensitivity analysis. Studies reported improvements in depression, anxiety, and quality of life.

This review consolidates the best available evidence on the effects of yoga interventions for tobacco cessation, showcasing the promising potential of yoga in smoking cessation.

Active yoga styles like hatha, vinyasa, and Iyengar improved 7PPA by reducing stress and depression, while pranayama reduced cravings and negative affect. Future research should explore yoga-based cessation programs in diverse settings, especially low- and middle-income countries, to address unique challenges. Standardizing methodologies across populations will enable a more comprehensive evaluation of yoga's role in tobacco cessation and its potential to enhance global public health outcomes.