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Evidence summaries

Individual Behavioural Counselling for Smoking Cessation

Smoking cessation counselling can assist smokers to quit. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 49 trials with over 19 000 participants. 33 trials compared individual counselling to a minimal behavioural intervention. Individual counselling was more effective than control 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 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.

A review and meta-analysis 2 included 19488 smoking subjects. The combination of medication and behavioral counseling was associated with a quit rate of 15.2% over 6 months compared with a quit rate of 8.6% with brief advice or usual care. Brief or intensive behavioral support can be delivered effectively in person or by telephone, text messages, or the internet. The combination of a clinician's brief advice to quit and assistance to obtain tobacco cessation treatment is effective when routinely administered to tobacco users in virtually all health care settings.

    References

    • Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev 2017;(3):CD001292. [PubMed]
    • Rigotti NA, Kruse GR, Livingstone-Banks J et al. Treatment of Tobacco Smoking: A Review. JAMA 2022;327(6):566-577. [PubMed]

Primary/Secondary Keywords