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Individual behavioural counselling for smoking cessation

Lancaster T and Stead LF (2017)

Cochrane Database of Systematic Reviews - 10.1002/14651858.CD001292.pub3.

Evidence Categories

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

Type of Evidence

Systematic Review

Aims

The review addresses the following hypotheses: 1. Individual counselling is more effective than no treatment or brief advice in promoting smoking cessation. 2. Individual counselling is more effective than self-help materials in promoting smoking cessation. 3. A more intensive counselling intervention is more effective than a less intensive intervention.

Findings

The authors identified 49 trials with around 19,000 participants. Thirty-three trials compared individual counselling to a minimal behavioural intervention. There was high-quality evidence that individual counselling was more effective than a minimal contact control (brief advice,usual care, or provision of self-help materials) when pharmacotherapy was not offered to any participants (RR 1.57, 95% confidence interval (CI) 1.40 to 1.77; 27 studies, 11,100 participants; I2 = 50%). There was moderate-quality evidence (downgraded due to imprecision) of a benefit of counselling when all participants received pharmacotherapy (nicotine replacement therapy) (RR 1.24, 95% CI 1.01 to 1.51; 6 studies, 2662 participants; I2 = 0%). There was moderate-quality evidence (downgraded due to imprecision) for a small benefit of more intensive counselling compared to brief counselling (RR 1.29, 95% CI 1.09 to 1.53; 11 studies, 2920 participants; I2 = 48%). None of the five other trials that compared different counselling models of similar intensity detected significant differences.

Conclusions

"There is high-quality evidence that individually-delivered smoking cessation counselling can assist smokers to quit. There is moderate-quality evidence of a smaller relative benefit when counselling is used in addition to pharmacotherapy, and of more intensive counselling compared to a brief counselling intervention."

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