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Interventions for Tobacco Cessation in Adults, Including Pregnant Women: An Evidence Update for the U.S. Preventive Services Task Force

Selph, S et al (2020)

Agency for Healthcare Research and Quality - Report No.: 19-05254-EF-

Evidence Categories

  • Care setting: Healthcare Setting
  • Population group: Pregnancy/ post-partum
  • Population group: Children & Young adults
  • Intervention: Bupropian
  • Intervention: Electronic Nicotine Delivery System
  • Intervention: Behaviour Support
  • Intervention: Nicotine Replacement Therapy
  • Outcome: Smoking cessation
  • Outcome: Changes to smoking rates

Type of Evidence

Systematic Review

Aims

To systematically update the 2013 U.S. Preventive Services Task Force (USPSTF) review on primary care relevant interventions for tobacco use prevention and cessation in children and adolescents.

Findings

Twenty-six trials met inclusion criteria. Behavioral interventions were associated with decreased likelihood of smoking initiation compared with control interventions (k=13, n=21,700; 7.4% vs. 9.2%; relative risk [RR] 0.82, 95% confidence interval [CI] 0.73 to 0.92). In trials restricted to smokers, behavioral interventions had no effect on smoking prevalence (k=9, n=2,516, 80.7% vs. 84.1% continued smoking, RR 0.97, 95% CI, 0.93 to 1.01). Behavioral interventions were more effective than control interventions at decreasing smoking prevalence in trials of smokers and nonsmokers (k=7, n=10,533; 16.8% vs. 20.1%; RR 0.91, 95% CI, 0.83 to 0.995). However, these results were sensitive to inclusion of two trials of very intensive interventions. Two trials of bupropion and one trial of nicotine replacement therapy found no significant benefits of medication on likelihood of smoking cessation. One trial each found no evidence for a beneficial intervention effect on health outcomes or on adult smoking.

Conclusions

Mae'r awduron yn datgan:

"Behavioral interventions can reduce the likelihood of smoking initiation in nonsmoking youth and young adults. Research is needed to identify effective behavioral interventions for youth who smoke or who use other tobacco products and to understand the effectiveness of pharmacotherapy on cessation. Due to the rapid escalation of e-cigarette use among youth, both prevention and cessation trials that target and/or include e-cigarettes are imminently needed."