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NICE Underpinning Review
The National Health Service (NHS) smoking cessation services in England provide interventions to affect smoking cessation across the population. This rapid review examines the effectiveness of the NHS intensive smoking cessation treatments in England. The review contains assessments of available data, in a background reflecting other relevant literature. The available data has been assessed to answer nine preset questions examining in detail the effectiveness of the NHS cessation services and their mode of delivery, delivery settings and their effects on specific sub-groups. This review was commissioned by the National Institute for Health and Clinical Excellence and the search was conducted before May 5 2006. A second search was conducted in September 2007 to identify any relevant literature published in 2006 and 2007.
There is a limited body of available evidence on many of the research questions posed for this rapid review. In many cases the quality of the evidence is low and in other cases there are very few available studies on the issue under examination. There are several general problems with the data that are routinely collected or embedded in intervention studies. These problems affect the comprehensiveness of the data, its generalisability and its utility in indicating intervention improvements and new research questions. There is also a general lack of sex and diversity-disaggregated data collection, reporting, and analysis, making it difficult to comprehensively answer some of the questions. As a result, it is not possible to fully describe and effectively analyse the specific patterns and needs of women and men, or of women and men of diverse ethnic groups and how any differences may have arisen. Nevertheless, while the body of evidence on the effectiveness of intensive smoking cessation treatments delivered through the NHS is not necessarily definitive, it does provide some useful indicative information on how effectively the services are operating.
Overall, there is a body of 3- and 2++ evidence that NHS intensive interventions for smoking cessation can be effective in both the short term (4 weeks) and long term (52 weeks). However, given that long-term follow up has proved both difficult and labour intensive, with extremely high rates of loss to follow up, the use of 4 week quit rates as a proxy indicator of long-term effectiveness seems justified.