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Evidence summaries

Interventions for Tobacco Use Cessation in People in Treatment for or Recovery from Substance Use Disorders

Pharmacotherapy alone or combined with counselling targeted to smokers in treatment and recovery for alcohol and other drug dependencies may be effective for tobacco cessation compared with placebo or usual care without affecting the abstinence of alcohol or drugs. Counselling alone may not be effective. Level of evidence: "C"

Comment: The quality of evidence is downgraded by study limitations and (lack of/unclear allocation concealment) and by suspected publication bias.

Summary

A Cochrane review [Abstract] 1 included 35 studies with a total of 5 796 subjects assessing the efficacy of tobacco cessation interventions, including counselling, and pharmacotherapy consisting of nicotine replacement therapy (NRT) or non-NRT, or the two combined. Pharmacotherapy and combined intervention increased tobacco abstinence, but counselling alone did not (table T1; low quality evidence). Interventions were significantly associated with tobacco abstinence for both people in treatment and people in recovery, and for people with alcohol dependence and people with other drug dependencies. Offering tobacco cessation therapy in treatment or recovery for other drug dependence was not associated with a difference in abstinence rates from alcohol and other drugs (RR 0.97, 95% CI 0.91 to 1.03; 11 studies, n=2231, moderate heterogeneity I²=66%).

Tobacco cessation interventions compared to placebo or usual care for people in treatment for or recovery from alcohol or other drug dependency

Outcome (abstinence assessed with biochemical validation)Relative effect(95% CI)Risk with placebo or usual careRisk with tobacco cessation interventions (95% CI)No of participants(studies)
Tobacco abstinence after counselling Follow-up: 6 weeks to 12 monthsRR 1.33(0.90 to 1.95)47 per 100062 per 1000(42 to 91)1759(11)
Tobacco abstinence after pharmacotherapy Follow-up:8 weeks to 6 monthsRR 1.60(1.22 to 2.12)79 per 1000126 per 1000(96 to 167)1808(11)
Tobacco abstinence after combined counselling and pharmacotherapy Follow-up: 13 weeks to 18 monthsRR 1.74(1.39 to 2.18)92 per 1000160 per 1000(128 to 201)2229(12)

Clinical comments

Note

Date of latest search: 2 August 2016

    References

    • Apollonio D, Philipps R, Bero L. Interventions for tobacco use cessation in people in treatment for or recovery from substance use disorders. Cochrane Database Syst Rev 2016;(11):CD010274. [PubMed]

Primary/Secondary Keywords