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Efficacy of interventions to combat tobacco addiction: C ochrane update of 2012 reviews
Author(s) -
HartmannBoyce Jamie,
Stead Lindsay F.,
Cahill Kate,
Lancaster Tim
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12291
Subject(s) - varenicline , smoking cessation , medicine , systematic review , nicotine replacement therapy , psychological intervention , relative risk , meta analysis , randomized controlled trial , quitline , psychiatry , confidence interval , medline , family medicine , pathology , political science , law
Background and aims The C ochrane C ollaboration is an international not‐for‐profit organization which produces and disseminates systematic reviews of health‐care interventions. This paper is the first in a series of annual updates of C ochrane reviews on tobacco addiction interventions. It also provides an up‐to‐date overview of review findings in this area to date and summary statistics for cessation reviews in which meta‐analyses were conducted. Methods In 2012, the Group published seven new reviews and updated 13 others. This update summarizes and comments on these reviews. It also summarizes key findings from all the other reviews in this area. Results New reviews in 2012 found that in smokers using pharmacotherapy, behavioural support improves success rates [risk ratio ( RR) 1.16, 95% confidence interval ( CI ) = 1.09–1.24], and that combining behavioural support and pharmacotherapy aids cessation ( RR 1.82, 95% CI = 1.66–2.00). Updated reviews established mobile phones as potentially helpful in aiding cessation ( RR 1.71, 95% CI = 1.47–1.99), found that cytisine ( RR 3.98, 95% CI = 2.01–7.87) and low‐dose varenicline ( RR 2.09, 95% CI = 1.56–2.78) aid smoking cessation, and found that training health professionals in smoking cessation improves patient cessation rates ( RR 1.60, 95% CI = 1.26–2.03). The updated reviews confirmed the benefits of nicotine replacement therapy, standard dose varenicline and providing cessation treatment free of charge. Lack of demonstrated efficacy remained for partner support, expired‐air carbon monoxide feedback and lung function feedback. Conclusions C ochrane systematic review evidence for the first time establishes the efficacy of behavioural support over and above pharmacotherapy, as well as the efficacy of cytisine, mobile phone technology, low‐dose varenicline and health professional training in promoting smoking cessation.