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Nursing interventions for smoking cessation

Rice VH et al (2017)

Cochrane Database of Systematic Reviews - 10.1002/14651858.CD001188.pub5.

Evidence Categories

  • Care setting: Healthcare Setting
  • Care setting: Community setting
  • Care setting: Workplace setting
  • Care setting: Educational Setting
  • Population group: Adults
  • Intervention: Behaviour Support
  • Outcome: Smoking cessation

Type of Evidence

Systematic Review

Aims

To determine the effectiveness of nursing-delivered smoking cessation interventions in adults. To establish whether nursing-delivered smoking cessation interventions are more effective than no intervention; are more effective if the intervention is more intensive; differ in effectiveness with health state and setting of the participants; are more effective if they include follow-ups; are more effective if they include aids that demonstrate the pathophysiological effect of smoking.

Findings

Pooling 44 studies (over 20,000 participants) comparing a nursing intervention to a control or to usual care, the authors found the intervention increased the likelihood of quitting (RR 1.29, 95% CI1.21 to 1.38); however, statistical heterogeneity was moderate (I2 = 50%) and not explained by subgroup analysis. Because of this, the authors judged the quality of evidence to be moderate. Subgroup analyses found no evidence that high-intensity interventions, interventions with additional follow-up or interventions including aids that demonstrate the pathophysiological effect of smoking are more effective than lower intensity interventions, or interventions without additional follow-up or aids. There was no evidence that the effect of support differed by patient group or across healthcare settings.

Conclusions

There is moderate quality evidence that behavioural support to motivate and sustain smoking cessation delivered by nurses can lead to a modest increase in the number of people who achieve prolonged abstinence. There is insufficient evidence to assess whether more intensive interventions, those incorporating additional follow-up, or those incorporating pathophysiological feedback are more effective than one-off support. There was no evidence that the effect of support differed by patient group or across healthcare settings.

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