A Cochrane review [Abstract] 1 included 17 trials. Trained professionals were more likely to counsel patients about smoking, and to initiate other interventions such as setting a quit date, suggesting a follow-up appointment, and offering self-help materials. No evidence of an effect for continuous smoking abstinence following the intervention was found in 13 trials. Meta-analysis of 14 studies for point prevalence of smoking produced a statistically and clinically significant effect in favour of the intervention (OR 1.36, 95% CI 1.20 to 1.55). Meta-analysis of 8 studies that reported continuous abstinence was also statistically significant (OR 1.60, 95% CI 1.26 to 2.03).
A prospective intervention study 2 assessing the effects of implementing standard operating procedures (SOPs) for the provision of counselling and pharmacotherapy to smokers admitted to cardiology wards included 150 patients (75 before and 75 after SOP implementation). Before the implementation of SOPs, the proportion of patients reporting to have received cessation counselling from physicians and nurses was 6.7% and 1.3%, respectively. Following SOP implementation, these proportions increased to 38.7% (p < 0.001) and 2.7% (p = 0.56), respectively. Qualitative analysis revealed that lack of motivation, e.g. role incongruence, appeared to be a major barrier.
Comment: The quality of evidence is downgraded by imprecise results (few outcome events).
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