Interventions for smoking cessation: An overview of Cochrane reviews

Chun-Li Lu; Jia-Xuan Li; Qian-Yun Wang; Rui-Ting Wang; Xing-Ru Pan; Xiao-Ying Chen; Chao-Jie Wang; Rui-Lin Chen; Si-Hong Yang; Zhi-Hui Zhao; Jing-Jing Jiang; Xue-Han Liu; Jian-Hua Wang; Xue Xue; Li-Rong Liang; Nicola Robinson; Jian-Ping Liu

doi:10.18332/tid/195302

Interventions for smoking cessation: An overview of Cochrane reviews

Tob Induc Dis. 2024 Nov 28:22. doi: 10.18332/tid/195302. eCollection 2024.

Authors

Chun-Li Lu^{1

2

3}, Jia-Xuan Li^#⁴, Qian-Yun Wang^#⁵, Rui-Ting Wang⁶, Xing-Ru Pan⁷, Xiao-Ying Chen⁸, Chao-Jie Wang⁹, Rui-Lin Chen¹⁰, Si-Hong Yang¹¹, Zhi-Hui Zhao¹², Jing-Jing Jiang¹³, Xue-Han Liu¹, Jian-Hua Wang¹⁴, Xue Xue^{4

15}, Li-Rong Liang¹⁶, Nicola Robinson^{1

17}, Jian-Ping Liu¹

Affiliations

¹ Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
² Guangdong Provincial Research Center of Integration of Traditional Chinese Medicine and Western Medicine in Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, China.
³ Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou, China.
⁴ School of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China.
⁵ Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
⁶ Cardiovascular Department Ward 3, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China.
⁷ Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
⁸ Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China.
⁹ Acupuncture and Moxibustion Massage College, Liaoning University of Traditional Chinese Medicine, Liaoning, China.
¹⁰ Department of Traditional Chinese Medicine, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Hubei, China.
¹¹ China Center for Evidence Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
¹² School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
¹³ Graduate Institute of Interpretation and Translation, Shanghai International Studies University, Shanghai, China.
¹⁴ School of Traditional Chinese Medicine, Liaoning University of Traditional Chinese Medicine, Liaoning, China.
¹⁵ Department of Nephrology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.
¹⁶ Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
¹⁷ Institute of Health and Social Care, London South Bank University, London, United Kingdom.

^# Contributed equally.

Abstract

Introduction: Evidence of different smoking cessation interventions varies and has been assessed in many Cochrane reviews. We conducted an overview of these Cochrane reviews to summarize the effects of current interventions for smoking cessation.

Methods: Nine databases were searched from their inception to October 2024, with no restrictions on language. Two authors independently extracted data from the same studies simultaneously, double checking after extraction. A second round of examination was conducted on all the extracted contents by another author. We employed a measurement tool to assess systematic reviews (AMSTAR-2) to evaluate the methodological rigor of the included systematic reviews (SRs), synthesized the GRADE results as reported, and conducted a narrative synthesis. The research protocol was registered on PROSPERO (CRD42023388884).

Results: Seventy-one Cochrane reviews involving 3022 trials were included in this comprehensive analysis. The two predominant smoking cessation interventions were pharmacotherapy (24 SRs) and non-pharmacological therapy (31SRs). Overall, the methodological quality of all the reviews was good. Compared with placebo, the point effect size for each Cochrane review on relative risk (RR) regarding pharmacotherapies for prolonged abstinence rate ranged from 1.11 to 3.34, demonstrating high- or moderate-certainty evidence; whereas for non-pharmacological therapies, it varied from 0.79 to 25.38, but substantial heterogeneity was observed in most meta-analysis (I2>50%). Four studies investigating pharmacotherapies as interventions, adverse events were reported but no significant differences in outcomes were observed.

Conclusions: Pharmacotherapy demonstrated some efficacy in promoting prolonged abstinence rate, while the effectiveness of different non-pharmacological interventions for smoking cessation varied widely, highlighting the need for further research on the integration of pharmacotherapy and non-pharmacological therapies.

Keywords: Cochrane review; overview; smoking cessation; systematic review; tobacco control.

Grants and funding

FUNDING This work was supported by the National Key Research and Development Project: Adding Chinese herbal medicine to antibiotic treatment for acute exacerbation of chronic obstructive pulmonary disease (Grant No. 2018YFE0102300). JPL, CLL and XHL were supported by Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No: ZYYCXTD-C-202006). CLL was supported by Guangzhou Municipal Science and Technology Bureau (2024A04J4734). JPL was supported by High-level traditional Chinese medicine key subjects construction project of National Administration of Traditional Chinese Medicine—— Evidence-based Traditional Chinese Medicine (zyyzdxk-2023249). XX was supported by Domestic Visitor Foundation from the Ministry of Education & National Administration of Traditional Chinese Medicine for the base construction project to finish research.