A Cochrane review [Abstract] 1 included 66 studies withover 20 000 subjects. There was an increase in smoking cessation with the use of a group programme compared to self-help programme T1. There was no evidence that group therapy was more effective than a similar intensity of individual counselling T1. There was limited evidence that the addition of group therapy to other forms of treatment, including advice from a health professional or nicotine replacement produced extra benefit. Programmes which included components for increasing cognitive and behavioural skills were not shown to be more effective than same length or shorter programmes without these components (RR 1.15, 95% CI 0.97 to 1.37; 8 studies, n= 1524).
| Outcome: Abstinence at 6 months or later - self-report, ± biochemical validation | Relative effect(95% CI) | Control: No quit | Intervention -Group prgramme: No quit (95% CI) | №of participants(studies) Quality of the evidence |
|---|---|---|---|---|
| Group programme compared to self-help | RR 1.88(1.52 to 2.33) | 5 per 100 | 9 per 100(8 to 12) | 4395(13) Moderate |
| Group programme compared to brief support | RR 1.25(1.07 to 1.46) | 5 per 100 | 6 per 100(5 to 7) | 7601(16) Low |
| Group programme compared to face-to-face individual intervention | RR 0.99(0.76 to 1.28) | 11 per 100 | 11 per 100(8 to 14) | 980(6) Moderate |
| Group programme plus pharmacotherapy versus pharmacotherapy and brief support alone | RR 1.11(0.93 to 1.33) | 18 per 100 | 20 per 100(17 to 24) | 1523(5) Moderate |
| Group programme versus 'no intervention' | RR 2.60(1.80 to 3.76) | 5 per 100 | 13 per 100(9 to 19) | 1098(9) Low |
A cluster-randomised controlled trial 2 in the Netherlands investigated financial incentives combined with a smoking cessation group training programme. The control group received a weekly 90-min session of smoking cessation group training for 7 weeks at the workplace; in addition to the group training, the intervention group received vouchers for being abstinent (€50 at the end of the training programme, €50 3 months after completion of the programme, €50 after 6 months, and €200 after 12 months). 12 months after finishing the smoking cessation programme, carbon monoxide-validated abstaining from smoking in the intervention group was significantly higher than that in the control group (131 [41%] of 319 vs 75 [26%] of 284; adjusted odds ratio 1.93, 95% CI 1.31 to 2.85, p=0.0009; adjusted for education level, income level, and Fagerström score).
A study 3 analyzed which factors were associated with quit success in the above mentioned trial. Social support from colleagues was positively associated with 12-month quit success (OR 1.85, 95% CI 1.14 to 3.00, p = 0.013) while having a higher proportion of smokers in the social environment was negatively associated (OR 0.81, 95% CI 0.71 to 0.92, p = 0.002). Support from a partner was positively associated with short-term quit success (OR 2.01, 95% CI 1.23 to 3.30, p = 0.006).
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