Objectives The objectives of this review and meta-analysis were twofold: first, to critically evaluate the effectiveness of cognitive behavioral therapy (CBT)-based interventions relative to standard care or control conditions in promoting smoking abstinence at the end of treatment, and second, to determine abstinence rates at 3 and 6 months of follow-up.
Methods A comprehensive search of electronic databases, including PubMed, Cochrane Library, PsycINFO, Embase, and ClinicalTrials.gov, was conducted for randomized controlled trials published from 2001 to September 2024. Studies evaluating the effect of CBT on abstinence rates among healthy smokers (aged ≥12 years) were included and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results Out of 1,514 study records screened, 7 studies (comprising 17 arms and 1,438 participants) met eligibility criteria for inclusion in the final analysis. The pooled analysis revealed that CBT significantly improved smoking abstinence rates, demonstrating a fourfold increase in effectiveness compared to controls (odds ratio [OR], 4.04; 95% confidence interval [CI], 2.73–5.99; I2=19%; p<0.00001). Additionally, CBT significantly impacted smoking cessation at 3-month follow-up (OR, 1.62; 95% CI, 1.11–2.38; I2=0%; p=0.01) and 6-month follow-up (OR, 2.19; 95% CI, 1.59–3.00; I2=0%; p<0.00001).
Conclusion CBT has demonstrated efficacy in facilitating smoking abstinence, particularly immediately after treatment, with sustained but diminished effects over time. However, robust conclusions on the efficacy of CBT require further studies involving larger sample sizes, diverse geographical regions, and longer follow-up periods.
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Objectives This review and meta-analysis examined the effectiveness of non-pharmacological therapies delivered through school-based interventions for smoking cessation among adolescents in South and Southeast Asian countries.
Methods A systematic search was conducted across PubMed, Scopus, Science Direct, BioMed Central, the Cochrane Library, and ProQuest Dissertations & Theses Global from inception to October 2024. Eligible studies comprised randomized controlled trials and quasi-experimental studies that compared non-pharmacological smoking cessation interventions delivered in schools or other educational institutions. Data on smoking abstinence outcomes were extracted from published studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model via the Mantel-Haenszel estimator.
Results Seven studies involving 1,260 participants were included. The meta-analysis demonstrated that non-pharmacological school-based therapies significantly increased smoking abstinence compared to controls (OR, 2.83; 95% CI, 1.83–4.40; p<0.001. Subgroup analyzes revealed benefits across both randomized controlled trials and quasi-experimental studies with varying abstinence rates. Studies utilizing biochemical verification showed significant positive effects despite substantial heterogeneity, and short-term (<3 months) abstinence was significantly higher in intervention groups compared to controls. Overall, no differences were found between subgroups regarding intervention effectiveness.
Conclusion This meta-analysis indicates that non-pharmacological school-based interventions positively impact smoking abstinence rates, although effectiveness may vary based on study design, follow-up duration, and use of biochemical verification. The findings underscore the need for further research with larger sample sizes, extended follow-up periods, and improved methodological rigor in these regions.
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Objectives
This study aimed to assess the effectiveness of relapse prevention interventions involving behavioral and pharmacological treatment among abstinent smokers.
Methods
This rapid review was conducted using MEDLINE, Cochrane CENTRAL, CINAHL, Embase, KMbase, and KoreaMed to identify studies published until June 20, 2020. The participants were abstinent smokers who quit smoking on their own, due to pregnancy, hospitalization, or by participating in a smoking cessation program. We found a systematic review that fit the objective of this study and included 81 randomized controlled trials (RCTs). Studies that did not present information on smoking cessation status, had no control group, or used reward-based interventions were excluded. Random effect and fixed effect meta-analyses were used to estimate the relative risk (RR) and 95% confidence interval (CI). In subgroup analyses, differences between subgroups were verified based on the participant setting, characteristics, intervention type, and intensity.
Results
Following screening, 44 RCTs were included in the meta-analysis. The review reported no differences in the success rate of relapse prevention between the behavioral interventions. Pharmacotherapy interventions showed higher success rates (RR, 1.15; 95% CI, 1.05−1.26; <i>I</i><sup>2</sup>=40.71%), depending on prior abstinence duration and the drug type. Conclusions: The results indicated that pharmacotherapy has a significant effect on preventing relapse among abstinent smokers.
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Knowledge user involvement is still uncommon in published rapid reviews—a meta-research cross-sectional study Barbara Nussbaumer-Streit, Dominic Ledinger, Christina Kien, Irma Klerings, Emma Persad, Andrea Chapman, Claus Nowak, Arianna Gadinger, Lisa Affengruber, Maureen Smith, Gerald Gartlehner, Ursula Griebler Research Synthesis Methods.2025; 16(6): 876. CrossRef
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Objectives
The aim of this study was to evaluate the effectiveness of behavioral smoking cessation interventions among adolescents.
Methods
MEDLINE, CENTRAL, Embase, CINAHL, KoreaMed, and KMbase were searched from inception to June 2020. Systematic reviews (SRs) or meta-analyses of randomized controlled trials (RCTs) were initially searched to perform a rapid SR. After selecting the final SR, RCTs after the publication year of the selected SR were searched. The primary outcome was smoking status after at least 6 months of follow-up, and the secondary outcome was smoking status at 4 weeks. Two reviewers independently assessed the selected studies’ quality using the Cochrane risk of bias tool. The meta-analysis utilized a Mantel-Haenszel fixed-effect model reporting the relative risk (RR) and 95% confidence interval (CI). The subgroup analysis utilized Cochrane’s Q.
Results
Thirty-two RCTs (11,637 participants) from a single SR were meta-analyzed. After 6 months of follow-up, the intervention group had significantly higher abstinence rates (RR, 1.30; 95% CI, 1.20−1.41; I2=26.46%). At 4 weeks of follow-up, the intervention group also had significantly higher abstinence rates (RR, 1.92; 95% CI, 1.49–2.47; I2=0.00%). The subgroup analysis indicated a significant difference in the abstinence rate according to the study setting and the period between intervention completion and follow-up.
Conclusion
This review showed that adolescent behavioral smoking cessation intervention programs significantly increased abstinence rates compared to the usual care.
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<sec>
<title>Objectives</title>
<p>The purpose of this study was to investigate the factors involved in the success of smoking cessation in heavy smokers enrolled in an intensive care smoking cessation camp program.</p></sec>
<sec>
<title>Methods</title>
<p>Heavy smokers enrolled in the program were classified into a success (<italic>n</italic> = 69) or failure (<italic>n</italic> = 29) group, according to whether they maintained smoking cessation for 6 months after the end of the program. Demographics, smoking behaviors, and smoking cessation-related characteristics were analyzed.</p></sec>
<sec>
<title>Results</title>
<p>Statistically significantly more participants in the success group had a spouse (98.6%; <italic>p</italic> = 0.008) compared with participants in the failure group (82.8%). However, multivariate logistic regression analysis indicated that having a spouse was not an independent factor in smoking cessation (<italic>p</italic> = 0.349). A significant difference in the frequency of counseling between the success and failure groups was observed (<italic>p</italic> = 0.001), with 72.5% of those who received counseling on 3–5 occasions for 6 months after the end of program successfully quit smoking, indicating that those who received more counseling had a higher likelihood of smoking cessation success. This was confirmed as an independent factor by multivariate logistic regression (<italic>p</italic> < 0.005). Furthermore, a graduate school level of education or higher, indicated a statistically greater success rate compared to those that were less well educated (<italic>p</italic> = 0.043). This was also observed as a significant independent factor using multivariate logistic regression (<italic>p</italic> = 0.046).</p></sec>
<sec>
<title>Conclusion</title>
<p>Education level, marital status, and the number of counseling sessions were significant factors contributing to smoking cessation success.</p></sec>
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<sec>
<title>Objectives</title>
<p>This study was conducted to evaluate whether a “smoking cessation intervention” education program based on blended learning, was effective in improving nursing students’ perceived competence and motivation to perform a smoking cessation intervention for smokers.</p></sec>
<sec>
<title>Methods</title>
<p>A quasi-experimental, pretest–posttest design was conducted. The smoking cessation intervention education program based on blended learning, was administered to the experimental group (<italic>n</italic> = 23) in 5 sessions, consisting of 2 courses of an e-learning program and 1 course of a face-to-face learning program per session. The control group (<italic>n</italic> = 21) received the opportunity to participate in an e-learning program as well as receiving material of a face-to-face learning program, after completion of the smoking cessation intervention education program.</p></sec>
<sec>
<title>Results</title>
<p>The experimental group showed significant differences in autonomous motivation (<italic>t</italic> = −6.982, <italic>p</italic> < 0.001), controlled motivation (<italic>t</italic> = −3.729, <italic>p</italic> = 0.001), and perceived competence compared to the control group (<italic>t</italic> = −3.801, <italic>p</italic> < 0.001).</p></sec>
<sec>
<title>Conclusion</title>
<p>This study showed that a smoking cessation intervention education program adopting blended learning, was significantly effective in enhancing nursing students’ autonomous motivation and perceived competence to conduct a smoking cessation intervention. Further studies are needed to confirm longitudinal effects of this program.</p></sec>
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Objectives
Nurses have been identified as an instrumental partner in tobacco reduction. This study aimed to examine factors affecting Korean nurses' intention to implement smoking cessation intervention in Busan, Korea. Methods
The participants were a total of 215 Korean registered nurses. A self-administered questionnaire evaluated predisposing factors, motivational factors (attitude, social influence, and self-efficacy) and intention to implement smoking cessation intervention. Data were analyzed by <i>t</i> tests, Pearson's correlation, and hierarchical multiple regression. Results
The mean age of the participants was 28.12 ± 5.72 years. The majority of the participants were staff nurses (85.6%), and 64.2% of the sample had < 5 years of work experience. Significant predictors of intention to implement smoking cessation intervention included perceived barrier of smoking cessation intervention (β = −0.128, <i>p</i> = 0.023), willingness to receive smoking cessation training (β = 0.123, <i>p</i> = 0.034), more positive attitude (β = 0.203, <i>p</i> = 0.002), higher social influence (β = 0.292, <i>p</i> < 0.001), and higher self-efficacy toward smoking cessation intervention (β = 0.151, <i>p</i> = 0.021), which explained 45% of the total variance of intention to implement smoking cessation intervention. Conclusion
Attitude, social influence, and self-efficacy towards smoking cessation intervention had a significant positive influence in determining the intention to implement smoking cessation intervention. These findings can be used to develop evidence-based smoking cessation training programs for nurses in Korea. The programs should aim for positive attitude, higher social influence, and higher self-efficacy in hospital settings.
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