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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The Development and Implementation of a Multimodal Preoperative-specific Smoking Cessation Project Mary Ann Z. de Vera, Rashmi J. Patel, Andrea H. Kline-Simon, Felicia W. Chi, Kelly C. Young-Wolff Journal of PeriAnesthesia Nursing.2026; 41(3): 564. CrossRef
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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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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>This study aimed to determine the factors associated with reducing exposure to secondhand smoke among children in households of rural Bangladesh.</p></sec>
<sec>
<title>Methods</title>
<p>A cross-sectional study of 410 smokers and non-smokers, in 6 villages of Munshigonj district was conducted. Data were collected randomly using a self-administrative questionnaire. Differences between variables were assessed using Chi-square or Fisher’s exact test (as appropriate). Univariate and multivariate logistic regression models were used to investigate associations. All results were presented as unadjusted and adjusted odds ratios with a 95% confidence interval. The level of statistical significance was reached when <italic>p</italic> < 0.05.</p></sec>
<sec>
<title>Results</title>
<p>A smoker in the household was determined to be a risk factor associated with exposure of other household members to secondhand smoke (<italic>p</italic> < 0.001). Higher education, strict implementation of household smoke-free rules, a higher influence of social norms and culture, as well as moderate knowledge on exposure to secondhand smoke were considered as preventive factors associated with exposure of others in the home to secondhand smoke.</p></sec>
<sec>
<title>Conclusion</title>
<p>Exposure to secondhand smoke is an extensive and preventable risk factor for children, and reducing exposure to secondhand smoke will have a largely positive effect in the community. An effective public health intervention model may reduce secondhand smoking.</p></sec>
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<sec>
<title>Objectives</title>
<p>This study aimed to analyze nationwide representative data from the 11<sup>th</sup> Korean Youth Health Risk Behavior Web-Based Survey to determine whether factors including socio-demographics, smoking and alcohol consumption, were factors related to high school students that had experienced sexual intercourse.</p></sec>
<sec>
<title>Methods</title>
<p>A total of 33,744 students (17,346 boys and 16,398 girls) in 1<sup>st</sup>, 2<sup>nd</sup>, and 3<sup>rd</sup> grade at high school were analyzed. SPSS complex samples methods were used for analyses. Socio-demographic and health risk behaviors (type of region of residence, family structure, and economic status, student academic achievement, gender, high school grade, pocket money, student smoking, alcohol consumption, and having engaged in sexual intercourse) were considered as independent variables.</p></sec>
<sec>
<title>Results</title>
<p>There were 3.6% of girls and 9.9% of boys in high school that were sexually active. This behavior and the average number of cigarettes smoked daily, and alcohol consumed weekly, represented a dose-response relationship, after considering confounding factors. Compared with students that did not smoke or consume alcohol, smoking 1–9 cigarettes per day and consuming 1–6 cups of alcohol and group “smoking more than 10 cigarettes per day and consuming more than 7 cups of alcohol, had a 5.94 and 22.25 higher risk of having had sexual intercourse, respectively.</p></sec>
<sec>
<title>Conclusion</title>
<p>Cigarette smoking and alcohol consumption were associated with an increased likelihood of high school students engaging in sexual intercourse.</p></sec>
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<sec>
<title>Objectives</title>
<p>Harmful alcohol consumption is associated with considerable social and economic damage to individuals and society. Because gender and ethnic background influence alcohol intake differently, examining gender specific factors influencing harmful drinking is necessary. This study investigated gender differences in alcohol consumption, harmful drinking, and the associated factors among Korean adults.</p></sec>
<sec>
<title>Methods</title>
<p>We analyzed the data from the 2012–2015 Korean National Health and Nutrition Examination Survey. Data from survey participants aged 20–64 years (<italic>N</italic> = 18,581) were included. The Alcohol Use Disorders Identification Test was used for alcohol dependence, and pooled weights were used. Chi-squared tests and multiple logistic regression analyses were conducted.</p></sec>
<sec>
<title>Results</title>
<p>The prevalence of harmful alcohol use (Alcohol Use Disorders Identification Test score ≥ 16) was 10.7% in the total sample; 18.4% in men and 3.4% in women, which constituted a significant difference. Education, marital status, smoking, perceived stress, and depressive feeling were associated with harmful drinking in both genders. However, household income, occupation, and perceived health status were associated with harmful drinking only in men.</p></sec>
<sec>
<title>Conclusion</title>
<p>Since there are gender differences in harmful drinking and alcohol dependence, gender tailored prevention and intervention strategies for alcohol dependence are necessary including consideration of smoking, stress, and depressive feeling.</p></sec>
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<sec>
<title>Objectives</title>
<p>This study compared the nutritional status of children in low-income households in Indonesia whose fathers were either cigarette smokers or non-smokers.</p></sec>
<sec>
<title>Methods</title>
<p>A cross sectional study of 482 children aged 2–6 years was conducted, stratified by whether the fathers were non-smoking (<italic>n</italic> = 138) or smoking (<italic>n</italic> = 340). Mothers and smoking fathers were interviewed about socioeconomic status and cigarette expenditure, respectively. The nutritional status of children was defined by weight-for-age, height-for-age and weight-for-height.</p></sec>
<sec>
<title>Results</title>
<p>Both groups had similar income. Households with a father that smoked, spent 16.6% of their income on cigarettes. Children whose fathers did not smoke had higher height-for-age (−1.99 vs. −2.25 Z-score, <italic>p</italic> = 0.02) than children whose fathers smoked. Weight-for-age in children with fathers that did not smoke was greater (−1.49 vs. −1.64 Z-score) but not statistically significantly different to those children with fathers that smoked, nor was child weight-for-height (−0.46 vs. −0.45 Z-score). The prevalence of stunted growth was higher in the children with a father that smoked compared with those that had a father did not smoke (62.2 vs. 49.6%, <italic>p</italic> = 0.07, respectively). There were 28.3% of children underweight in homes where the fathers did not smoke, and 35.6% in households where the father smoked (<italic>p</italic> = 0.11). Wasting was observed in 4.4% children where fathers did not smoke and 4.7% where fathers did smoke.</p></sec>
<sec>
<title>Conclusion</title>
<p>With similar income constraints, the degree of height growth faltering was less in children whose fathers did not smoke, compared to those whose fathers did smoke.</p></sec>
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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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<sec>
<title>Objectives</title>
<p>To investigate the effect of smoking upon cardiopulmonary function, maximal oxygen uptake, and obesity index, in middle-aged and older workers to propose guidelines on healthcare for these age groups.</p></sec>
<sec>
<title>Methods</title>
<p>This study analyzed medical data from 2,753 white-collar workers aged 50 years or older from workplaces located in Seoul, South Korea. Blood pressure (BP), resting heart rate, maximal oxygen uptake (VO<sub>2</sub>max), and body mass index (BMI) of each subject were measured. The collected data were analyzed using SPSS 21.0.</p></sec>
<sec>
<title>Results</title>
<p>In the smoking group BP and resting heart rate were significantly higher than in the non-smoking and smoking-cessation groups (<italic>p</italic> < 0.05). In addition, VO<sub>2</sub>max was lower in the smoking group compared to the other 2 groups. BP closely correlated with resting heart rate, abdominal fat ratio, and BMI. BMI was the highest in the group that stopped smoking and, BMI and abdominal fat ratio negatively correlated with VO<sub>2</sub>max.</p></sec>
<sec>
<title>Conclusion</title>
<p>Smoking increases the risk of cardiopulmonary disease but obesity may be caused by stopping smoking. Therefore, healthcare guidelines on smoking cessation should also include nutritional advice.</p></sec>
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<sec><title>Objectives</title><p>This study aimed to identify the effects of anti-smoking public service announcements on the attitudes of Korean college students toward smoking.</p></sec><sec><title>Methods</title><p>This study involved students via convenience sampling from seven universities who were randomly assigned to four groups. All groups completed a preliminary questionnaire, before being shown a public service announcement twice, and then completed a post viewing questionnaire.</p></sec><sec><title>Results</title><p>For announcements with positive messages, the proportion of changes in beliefs and attitudes were 39.1% and 19.8%, respectively, whereas those with negative messages showed a greater proportion of changes in the beliefs (59.7%) and attitudes (40.3%). After adjusting for sex and change in belief, the message types and smoking status were identified as factors affecting the change in the participants attitudes. A negative message resulted in a greater change in attitudes (odds ratio [OR], 3.047; 95% confidence interval [CI], 1.847–5.053). Ever-smokers including current smokers showed a greater positive change in attitude than never-smokers (OR, 6.965; 95% CI, 4.107–11.812).</p></sec><sec><title>Conclusion</title><p>This study found that positive anti-smoking public service announcements were more effective on attitude change than negative messages. Additionally these announcements were more effective among viewers who were current smokers or had a prior smoking experience.</p></sec>
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Objectives
Identification of the causal impact of self-esteem on smoking stages faces seemingly insurmountable problems in observational data, where self-esteem is not manipulable by the researcher and cannot be assigned randomly. The aim of this study was to find out if weaker self-esteem in adolescence is a risk factor of cigarette smoking in a longitudinal study in Iran. Methods
In this longitudinal study, 4,853 students (14–18 years) completed a self-administered multiple-choice anonym questionnaire. The students were evaluated twice, 12 months apart. Students were matched based on coarsened exact matching on pretreatment variables, including age, gender, smoking stages at the first wave of study, socioeconomic status, general risk-taking behavior, having a smoker in the family, having a smoker friend, attitude toward smoking, and self-injury, to ensure statistically equivalent comparison groups. Self-esteem was measured using the Rosenberg 10-item questionnaire and were classified using a latent class analysis. After matching, the effect of self-esteem was evaluated using a multinomial logistic model. Results
In the causal fitted model, for adolescents with weaker self-esteem relative to those with stronger self-esteem, the relative risk for experimenters and regular smokers relative to nonsmokers would be expected to increase by a factor of 2.2 (1.9–2.6) and 2.0 (1.5–2.6), respectively. Conclusion
Using a causal approach, our study indicates that low self-esteem is consistently associated with progression in cigarette smoking stages.
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Objectives
Tobacco is an important risk factor for tuberculosis (TB) infection and TB disease. Identifying tobacco users and providing tobacco cessation services is expected to reduce the burden of TB. We assessed tobacco use among presumptive TB patients attending a tertiary hospital and their willingness to attend tobacco cessation services. Methods
A cross-sectional study was conducted among presumptive TB patients attending a designated microscopy center of a tertiary hospital in South India. All presumptive TB patients aged ≥ 18 years attending the designated microscopy center were interviewed using a semistructured interview schedule. Data on presumptive TB patient's age, sex, tobacco use and forms of tobacco, attempts to quit tobacco since 1 year, and willingness to attend a smoking cessation clinic in tertiary hospital were captured. History of use of tobacco in the past 1 month was considered as “tobacco use.”. Results
A total of 424 presumptive TB patients aged ≥ 18 years were interviewed. Tobacco use in the past 1 month was reported by 176 (41.5%, 95% confidence interval: 36.9–46.3%) presumptive TB patients. In total, 78 (18%) presumptive TB patients were eventually diagnosed with smear-positive pulmonary TB, of them 63 (80%) were tobacco users. Presumptive TB patients aged ≥ 30 years, male sex, and < 10 years of education were significantly associated with tobacco use. Of 176, a majority of 132 (75%) used some form of smoking. Of a total of 132 smokers, 70 (53%) were willing to avail of tobacco cessation services. Conclusion
Tobacco use among presumptive TB patients was high. Considering the high willingness to quit among smokers, proven brief interventions to help quit smoking can be tried.
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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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Objectives
This study was conducted in order to determine any correlation between experience of harmful shops and adolescent smoking and alcohol drinking in middle and high school students. Methods
The survey was conducted using a self-administered questionnaire online via the homepage of the Ministry of Education student Health Information Center; 1888 and 1563 questionnaires were used for middle and high school students, respectively, for a total of 3451 questionnaires in the final analysis. The collected data were processed using SPSS version 21.0 and examined using frequency analysis and hierarchical linear regression. Results
In this research, 8.3% of all participants were found to have experienced smoking and 17.0% alcohol drinking. Regarding the types of harmful shops, 81.8% said they had been to a gaming place; 21.2% to a lodging place; 16.0% to a sex and entertainment place; and 6.8% to a harmful sex industry location. Sociodemographic variables had a significant effect on adolescent smoking and alcohol drinking. Regarding environmental variables, a significant difference was observed for living with parents and school location. Among adolescent experience of harmful shops, both smoking and alcohol drinking showed a significant association with harmful sex industry locations. Conclusion
National government-level management and supervision on this issue will be necessary to prevent adolescent access to harmful shops, along with more studies exploring methods for implementation of policies with more systematic control of harmful shops.
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