A Cochrane review [Abstract] 1 included42 studies with a total of over 31 000 smokers. The most common setting for delivery of advice was primary care. Pooled data from 17 trials of brief advice versus no advice (or usual care) revealed a small but significant increase in quitting (RR 1.66, 95% CI 1.42 to 1.94). Amongst 11 trials where the intervention was judged to be more intensive the estimated effect was higher (RR 1.84, 95% CI 1.60 to 2.13) but there was no statistical difference between the intensive and minimal subgroups. Direct comparison of intensive versus minimal advice showed a small advantage of intensive advice (RR 1.37, 95% CI 1.20 to 1.56; 15 trials, n=9775), in high risk populations this effect of intensive advice was stronger (RR 1.65, 95% CI 1.35 to 2.03; 5 trials, n=3773). Direct comparison also suggested a small benefit of follow-up visits in 12 months follow-up: With-in trial comparison with follow-up vs. single visit (RR 1.52, 95% CI 1.08 to 2.14; 5 trials, n=1254) and subgroup of interventions including multiple visits (RR 2.22, 95% CI 1.84 to 2.68; 6 trials, n=4511). In one study, no significant differences in death rates at 20 years follow-up was.
US Preventive Services Task Force 2 assessed interventions for tobacco cessation. Behavioral interventions such as advise from clinicians were all associated with increased quit rates (RR 1.76, 95% CI 1.58 to 1.96) compared with minimal support or placebo at 6 months or longer.
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