Telephone Counselling for Smoking Cessation (2019)

2019 review of evidence concludes that quitlines are effective in helping smokers quit.

A 2019 update to the Cochrane review on telephone counselling for smoking cessation concluded that telephone counselling increses the chances of quitting successfully, whether or not th eperson is motivated to quit and regardless of whether they are recieving other quit support.

Matkin WOrdóñez-Mena JHartmann-Boyce J
Cochrane Database of Systematic Reviews, (2019), 2019(5)

Evidence for Quitline Practices (2014)

Reference document for quitlines to identify practices that may help improve their reach or quit rates, find rationale and references to help justify implementing new practices, and make decisions about whether or not to discontinue certain practices

Evidence for Quitline Practices – 2014 Update, is intended to provide clarity on the level of scientific evidence for 28 quitline practices, including providing free or reduced NRT, text messaging, e-referrals, etc. Each practice has been scored based on how well it helps quitlines increase either reach or efficacy (quit rates). Specific articles and key talking points are cited for each practice, including the CDC’s recently released "Best Practices for Comprehensive Tobacco Control Programs,” the Guide to Community Preventive Services, and numerous Cochrane reviews and other studies.

KIQNIC- Evidence for Quitline Practices- 2014 Update. North American Quitline Consortium. Phoenix, Arizona. April 2014.

Quitlines and patterns among adults with chronic diseases (2012)

2012 study shows Quitlines are accessed by smokers with chronic diseases.

In a demographic analysis of 195,057 tobacco users who enrolled with one of 15 state Quitlines between 2005 and 2008, 32.3% reported having at least one chronic illness. A seven-month follow-up survey of 3,250 of these smokers showed that 21.6% of those with diabetes and 19.7% of those with chronic obstructive pulmonary disease (COPD) had quit smoking.

Bush T, Zbikowski S, Mahoney L, Deprey M, Mowery P, Cerutti B. State Quitlines and Cessation Patterns Among Adults With Selected Chronic Diseases in 15 States, 2005–2008. Prev Chronic Dis. 2012; 9: E163.

Telephone counselling for smoking cessation (2009)

2009 analysis of decades of data concludes that Quitlines help smokers quit.

In 2009, a Cochrane review pooled the results to 44 trials comparing proactive telephone counselling to little or no counselling. The study concluded that telephone counselling is an effective smoking cessation support. At six month follow-up those receiving the intervention, a total of 12,388 participants, were approximately 29% more likely to be successful in their quit attempts than those who did not receive telephone counselling. Actual quit rates varied depending on the protocols used and additional interventions.

Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation (Review). The Cochrane Collaboration. 2009

Treating tobacco use and dependence (2008)

2008 clinical practice guidelines recommend using telephone counselling.

The United States Department of Health and Human services assessed the evidence for the effectiveness of Quitlines and determined they were effective smoking cessation interventions, grouping Quitline counselling with various types of face-to-face counselling.

Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. US Department of Health and Human Services, Rockville MD, May 2008

Effects of frequency and duration in phone counselling (2007)

2007 study shows Quitline success is linked to number of counselling calls.

In a large study including a total of 6,564 callers to the American Cancer Society's National Cancer Information Center, 30-day point prevalence quit rates at seven month follow-up were 11% for those receiving phone counselling compared to 8% of those who received only mailed self-help materials (P < 0.005). The study found evidence of a dose-response relationship, with participants receiving at least five calls to counsellors more likely to successfully quit than those randomized to the protocol with only three calls.

Rabius V, Pike KJ, Hunter J, Wiatrek D, McAlister AL. Effects of frequency and duration in telephone counselling for smoking cessation. Tobacco Control 2007;16 Suppl 1:i71–4.

Mobile phone text messaging and app‐based interventions for smoking cessation (2019)

An update of the 2006 Cochrane review reviewed the evidence surrounding the effectiveness of text messaging programs for smoking cessation.

We found that text messaging programmes may be effective in supporting people to quit, increasing quit rates by 50% to 60%. This was the case when they were compared to minimal support or were tested as an addition to other forms of stop‐smoking support. 

Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y, Dobson  R. Mobile phone text messaging and app‐based interventions for smoking cessation. Cochrane Database of Systematic Reviews 2019, Issue 10. Art. No.: CD006611. DOI: 10.1002/14651858.CD006611.p

Text messaging-based smoking cessation intervention: A narrative review (2018)

2018 review of 15 smoking cessation text message programs suggests that these programs have potential to be useful for smoking cessation.

About half of the interventions recruited adults (ages 30–40) and the other half targeted young adults (ages 18–29). Fourteen interventions sent text messages during the quit phase, 10 had a preparation phase and eight had a maintenance phase. The number of text messages and the duration of the intervention varied. All used motivational messages grounded in social cognitive behavioral theories, 11 used behavioral change techniques, and 14 used individually tailored messages. Eleven interventions also offered other smoking cessation tools. Three interventions yielded smoking cessation outcomes greater than the control condition.

Grace Kong, Daniel M. Ells, Deepa R. Camenga, Suchitra Krishnan-Sarin,
Text messaging-based smoking cessation intervention: A narrative review,
Addictive Behaviors,
Volume 39, Issue 5,
2014,

How do text‐messaging smoking cessation interventions confer benefit? A multiple mediation analysis of Text2Quit (2016)

Text message programs for smoking cessation confer benefits by improving participants' psychological processing surrounding smoking behaviour.

Text‐messaging programs for smoking cessation appear primarily to confer benefit by promoting improvements in the psychosocial processes related to quitting rather than through the use of extra‐programmatic smoking cessation treatments and services.

How do text‐messaging smoking cessation interventions confer benefit? A multiple mediation analysis of Text2Quit
Bettina B. Hoeppner Susanne S. Hoeppner Lorien C. Abroms. Addiction (2016)

Cost-effectiveness of support delivered by text (2011)

2011 study demonstrates text support doubles the chances of quitting.

A prospective, blinded and randomized trial published in 2011 with 5800 participants. The researchers discovered that in the long-term, text support programs can double the quit success of participants. The intervention group had a 10.7% biochemically verified 6 month continuous abstinence quit rate, whereas the control group’s quit rate was 4.9% (P < 0.0001). Those in the intervention group that used other cessation products or services had an even higher quit rate of 14.6%.

The intervention was helpful for smokers of all levels of addiction. A cost-effectiveness analysis of the text to stop program determined that text support programs are likely to result in a net savings to the healthcare system.

Guerriero C, Cairns J, Roberts I, Rodgers A, Whittaker R, Free C. The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop. European Journal of Health Economics, 2012

Digital multi-media smoking cessation interventions (2008)

2008 trial shows text, email and web support can increase quit success.

A trial in Norway published in 2008 followed 396 participants using various aspects of a fully-automated cessation support intervention that included text support support along with email and web support. The trial found 12 month point prevalence of cessation among the text support group to be 37.6% compared to 24.1% in the control group (P = 0.005). A full 92.9% of participants in the text support group found the automated support to be “helpful” or “very helpful”.

Brendryen H, Kraft P. Happy Ending: a randomized controlled trial of a digital multi-media smoking cessation intervention. Addiction, 2008;103:478–84

Coping strategies and social support in a mobile phone chat app designed to support smoking cessation: Qualitative analysis (2018)

This study aimed to identify emotions, coping strategies, beliefs, values, and cognitive evaluations of smokers who are in the process of quitting, and to analyze online social support provided through the analysis of messages posted to a chat function integrated into a mobile app.

Our analysis suggests that a chat integrated into a mobile app focused on supporting smoking cessation provides a useful tool for smokers who are in the process of quitting, by offering social support and a space to share concerns, information, or strategies.

Granado-Font E, Ferré-Grau C, Rey-Reñones C, Pons-Vigués M, Pujol Ribera E, Berenguera A, Barrera-Uriarte ML, Basora J, Valverde-Trillo A, Duch J, Flores-Mateo G
Coping Strategies and Social Support in a Mobile Phone Chat App Designed to Support Smoking Cessation: Qualitative Analysis
JMIR Mhealth Uhealth 2018;

Motivational benefits of social support and behavioural interventions for smoking cessation (2018)

Social support and behavioural interventions are associated with higher intentions to quit among attempters who relapsed and thus, may aid future smoking cessation.

Those who use social support and behavioural interventions have higher odds of intending to quit than those who do not use such interventions.

Julia N. Soulakova, Chiung-Ya Tang, Selena A. Leonardo and Lindsay A. TaliaferroJournal of Smoking Cessation , Volume 13 , Issue 4 , December 2018 ,

Harnessing Facebook for smoking reduction and cessation interventions: Facebook user engagement and social support predict smoking reduction (2017)

This study is the first Facebook group–based intervention that systemically implemented health communication strategies and engagement and social support systems to promote smoking reduction and cessation

Our findings imply that receiving one like or posting on the Facebook-based intervention platform predicted smoking approximately one less cigarette in the past 7 days, and that interventions should facilitate user interactions to foster user engagement and social support.

Kim SJ, Marsch LA, Brunette MF, Dallery J
Harnessing Facebook for Smoking Reduction and Cessation Interventions: Facebook User Engagement and Social Support Predict Smoking Reduction
J Med Internet Res 2017

Online social support for the prevention of smoking relapse: A content analysis of the WhatsApp and Facebook social groups (2017)

A content analysis of online social support via Facebook and WhatsApp concluded that the peer support and information sharing through these platforms aids in preventing smoking relapse.

Online social groups provided a useful platform for the delivery of cessation support and encouragement of reporting abstinence, which support relapse prevention. The effectiveness of such intervention can be improved by encouraging more self-report of relapse, active discussions, sharing of interesting content, and using an appropriate discussion platform.

Yee Tak Derek Cheung, Ching Han Helen Chan, Man Ping Wang, Ho Cheung William Li, and Tai-hing Lam.Telemedicine and e-Health.Jun 2017

Relations and smoking abstinence among ever-smokers (2013)

This study aimed to assess which aspects of social relations were associated with smoking abstinence among ever-smokers. 

Contact with and support from close counterparts tended to be associated with an increased probability of smoking absitence and contact with or support from more distant counterparts tended to be associated with a decreased probability of abstinence

Ross L, Thomsen BL, Boesen SH, et al. Social relations and smoking abstinence among ever-smokers: A report from two large population-based Danish cohort studies. Scandinavian Journal of Public Health. 2013;

 

Social network structure of a large quitter community (2010)

The dynamics of smoking in a large social network (2008)

Patients’ awareness of the surgical risks of smoking (2015)

2015 study surveyed elective surgery patients in northern BC who identified as current smokers, to assess knoweldge of risks of pre-surgery smoking and awareness of available quit supports.

Many surgical patients in northern British Columbia who smoked are unaware of the perioperative risks of smoking and the cessation support available to them. An opportunity exists for all health care professionals to encourage more patients to quit in order to optimize their surgical outcomes.

Patients’ awareness of the surgical risks of smoking
Implications for supporting smoking cessation
Joan L. Bottorff, Cherisse L. Seaton and Sonia Lamont
Canadian Family Physician December 2015, 61 (12) e562-e569;

Efficacy of preoperative smoking cessation programs (2015)

Review of pre-surgical smoking cessation interventions to assess the effectiveness of pre-operative programs in achieving long-term cessation.

The literature suggests that preoperative smoking cessation programs will likely precipitate long-term (≥12 months) cessation.

Will Preoperative Smoking Cessation Programs
Generate Long-Term Cessation? A Systematic
Review and Meta-Analysis
Nicholas L. Berlin, MD, MPH; Christina Cutter, MD, MSc; and Catherine Battaglia, PhD, RN Am J Manag Care. 2015;21(11):e623-e631

Short term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis (2012)

2012 systematic review concludes smokers who quit before surgery have fewer complications.

The objective of a large 2012 review was to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications. Based on an analysis of 25 studies, it reports that smokers who quit more than four weeks before surgery had lower risk of respiratory and wound-healing complications than current smokers. Quitting less than four weeks before surgery did not appear to increase or decrease postoperative respiratory complications.

Wong J, Lam DP, Abrishami A, Chan M, & Chung F.  Short term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Canadian Journal of Anesthesia 2012; 59: 268-279. 

Wound healing and infection in surgery (2012)

2012 systematic review concludes smoking delays healing in surgical patients.

The objective of a large 2012 systematic review was to clarify how smoking and nicotine affects wound healing processes and to establish if smoking cessation and nicotine replacement therapy reverse the mechanisms involved. In total, 177 articles were included. The author concludes that smoking has a prolonged effect on inflammatory and reparative cell functions leading to delayed healing and complications. Smoking cessation restores the tissue microenvironment rapidly and the inflammatory cellular functions within four weeks.

Sorensen LT.  Wound healing and infection in surgery.  The pathophysiological impact of smoking, smoking cessation and nicotine replacement therapy.  Annals of Surgery 2012;  255: 1069-1079. 

Smoking cessation before surgery (2012)

2012 systematic review demonstrates cessation interventions are effective for surgical patients

The objective of the review was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Eight random controlled trials were included. The analysis demonstrates both intensive and brief intervention significantly increase smoking cessation at the time of surgery. Interventions that begin four to eight weeks before surgery, include weekly counseling, and use nicotine replacement therapy are more likely to have an impact on long-term smoking cessation.

Thomsen T, Villebro N, & Møller AM. Interventions for preoperative smoking cessation. Cochrane Database of Systematic Reviews 2010; Issue 7. Art. No.: CD002294. DOI: 10.1002/14651858.CD002294.pub3.

Smoking and surgical complications (2012)

2012 systematic review concludes smokers who quit before surgery have fewer complications.

The objective of a large 2012 review was to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications. Based on an analysis of 25 studies, it reports that smokers who quit more than four weeks before surgery had lower risk of respiratory and wound-healing complications than current smokers. Quitting less than four weeks before surgery did not appear to increase or decrease postoperative respiratory complications.

Wong J, Lam DP, Abrishami A, Chan M, & Chung F. Short term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Canadian Journal of Anesthesia 2012; 59: 268-279.

Interventions for preoperative smoking cessation (2011)

2012 systematic review demonstrates cessation interventions are effective for surgical patients 

The objective of the review was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Eight random controlled trials were included. The analysis demonstrates both intensive and brief intervention significantly increase smoking cessation at the time of surgery. Interventions that begin four to eight weeks before surgery, include weekly counseling, and use nicotine replacement therapy are more likely to have an impact on long-term smoking cessation. 

Thomsen T, Villebro N, & Møller AM. Interventions for preoperative smoking cessation. Cochrane Database of Systematic Reviews 2010; Issue 7. Art. No.: CD002294. DOI: 10.1002/14651858.CD002294.pub3. 

Fears of quitting immediately before surgery unfounded (2011)

2011 study demonstrates that quitting shortly before surgery is safe.

The 2011 study demonstrates concerns that stopping smoking shortly before surgery (less than eight weeks) may increase postoperative pulmonary complications are unsubstantiated. Although it may take several weeks to derive pulmonary benefits to quitting, clinicians are advised that “any time is a good time” to encourage pre-surgical patients to quit smoking.

Shi Y & Warner DO. Brief preoperative smoking abstinence: Is there a dilemma? Anesthesia and Analgesia 2011; 113:1348 -1351.

Smoking and surgical outcomes (2011)

2011 study finds increased mortality among surgical patients who smoke.

The surgical outcomes of current smokers and never smokers were examined in a large US cohort comparison involving a sample of 520,795 non-cardiac surgical patients. The researchers found that smoking was associated with a 40% greater chance of 30-day mortality and a 30-100% greater chance of major morbidity including surgical site infection, pneumonia, unplanned intubation and septic shock.

Turan A, Mascha EJ, Roberman D, et al. Smoking and perioperative outcomes. Anesthesiology 2011; 114: 837-46.

Surgery as a teachable moment (2010)

2010 study finds surgical patients are willing to quit.

In a large nationally representative longitudinal study of 5,498 patients conducted in the US, researchers found that undergoing major surgery approximately doubled the chances that a smoker would quit.

Shi Y, & Warner DO. Surgery as a teachable moment for smoking cessation. Anesthesiology 2010; 112(1):102-7.

Group behaviour therapy programmes for smoking cessation (2017)

Group support can increase chances of quitting successfully by at least 50%.

There was a benefit for the group-based approach, with the chance of quitting increased by 50% to 130%. This means that if five in 100 people were able to quitfor at least six months using self-help materials, eight to 12in 100 might be successful if offered group support.

Stead LF, Carroll AJ, Lancaster T.Group behaviour therapy programmes for smoking cessation.Cochrane Database of Systematic Reviews2017, Issue 3.

Individual behavioural counselling for smoking cessation (2017)

Behavioural counselling can increase the chances of quitting successfully by 40-80%.

individual counselling could increase the chance of quitting by between 40% and 80%, compared to minimal support. This success rate is likely modestly greater for intensive counselling and when counselling is combined with pharmacotherapy.

Lancaster  T, Stead  LF. Individual behavioural counselling for smoking cessation. Cochrane Database of Systematic Reviews 2017,

Combined counselling and cessation medication (2016)

Using a combination of behavioural support and medication increases the chances of successfully quitting after at least six months.

Interventions that combine pharmacotherapy and behavioural support increase smoking cessation success in a wide range of settings and populations, compared to a minimal intervention or usual care. This suggests that clinicians should encourage smokers to use both types of aid. 

Stead  LF, Koilpillai  P, Fanshawe  TR, Lancaster  T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database of Systematic Reviews 2016, Issue 3. Art. No.: CD008286.