Abstract
Aims: To summarize evidence for the efficacy of smoking cessation interventions in low- and middle-income countries (LMICs). Design: Systematic review and meta-analysis of randomized controlled trials. Setting: LMICs as defined by the World Bank. Participants: Adult current cigarette smokers residing in LMICs. Interventions: Behavioral and/or pharmacotherapy smoking cessation interventions. Measurements: PubMed MEDLINE, EMBASE (embase.com), Cochrane Central Register of Controlled Trials (Wiley), PsycINFO (Ebsco), SciELO, WHO Global Index Medicus and Scopus were searched from inception to 4 April 2018. Only studies with at least 6 months of follow-up were included. We used the most rigorous assessment of abstinence reported by each study. Effect sizes were computed from abstracted data. Where possible, a meta-analysis was performed using Mantel–Haenzel random-effect models reporting odds ratios (OR) and 95% confidence intervals (CI). Findings: Twenty-four randomized controlled trials were included. Six investigated the efficacy of pharmacological agents. Four trials that compared nicotine replacement therapy (NRT) to placebo found NRT improved cessation rates (n : NRT 546, control 684, OR = 1.76, 95% CI = 1.30–2.77, P < 0.001, I 2 = 13%). Eight trials found that behavioral counseling was more effective than minimal interventions (e.g. brief advice); n : Counseling 2941, control 2794, OR = 6.87, 95% CI = 4.18–11.29, P < 0.001, I 2 = 67%). There was also evidence of the benefit of brief advice over usual care (n : Brief advice 373, control 355, OR = 2.46, 95% CI = 1.56–3.88, P < 0.001, I 2 = 0%). Conclusion: Nicotine replacement therapy, behavioral counseling and brief advice appear to be effective in aiding smoking cessation in low- and middle-income countries. There is limited rigorous research on other smoking cessation interventions in these regions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 620-635 |
| Number of pages | 16 |
| Journal | Addiction |
| Volume | 114 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2019 |
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Keywords
- Developing countries
- low- and middle-income countries
- meta-analysis
- smoking cessation
- systematic review
- tobacco use
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Psychiatry and Mental health
Cite this
}
The efficacy of smoking cessation interventions in low- and middle-income countries : a systematic review and meta-analysis. / Akanbi, Maxwell Oluwole; Carroll, Allison Jane; Achenbach, Chad J; O'Dwyer, Linda; Jordan, Neil; Hitsman, Brian L; Bilaver, Lucy Ann; McHugh, Megan Colleen; Murphy, Robert Leo.
In: Addiction, Vol. 114, No. 4, 01.04.2019, p. 620-635.Research output: Contribution to journal › Review article
TY - JOUR
T1 - The efficacy of smoking cessation interventions in low- and middle-income countries
T2 - a systematic review and meta-analysis
AU - Akanbi, Maxwell Oluwole
AU - Carroll, Allison Jane
AU - Achenbach, Chad J
AU - O'Dwyer, Linda
AU - Jordan, Neil
AU - Hitsman, Brian L
AU - Bilaver, Lucy Ann
AU - McHugh, Megan Colleen
AU - Murphy, Robert Leo
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Aims: To summarize evidence for the efficacy of smoking cessation interventions in low- and middle-income countries (LMICs). Design: Systematic review and meta-analysis of randomized controlled trials. Setting: LMICs as defined by the World Bank. Participants: Adult current cigarette smokers residing in LMICs. Interventions: Behavioral and/or pharmacotherapy smoking cessation interventions. Measurements: PubMed MEDLINE, EMBASE (embase.com), Cochrane Central Register of Controlled Trials (Wiley), PsycINFO (Ebsco), SciELO, WHO Global Index Medicus and Scopus were searched from inception to 4 April 2018. Only studies with at least 6 months of follow-up were included. We used the most rigorous assessment of abstinence reported by each study. Effect sizes were computed from abstracted data. Where possible, a meta-analysis was performed using Mantel–Haenzel random-effect models reporting odds ratios (OR) and 95% confidence intervals (CI). Findings: Twenty-four randomized controlled trials were included. Six investigated the efficacy of pharmacological agents. Four trials that compared nicotine replacement therapy (NRT) to placebo found NRT improved cessation rates (n : NRT 546, control 684, OR = 1.76, 95% CI = 1.30–2.77, P < 0.001, I 2 = 13%). Eight trials found that behavioral counseling was more effective than minimal interventions (e.g. brief advice); n : Counseling 2941, control 2794, OR = 6.87, 95% CI = 4.18–11.29, P < 0.001, I 2 = 67%). There was also evidence of the benefit of brief advice over usual care (n : Brief advice 373, control 355, OR = 2.46, 95% CI = 1.56–3.88, P < 0.001, I 2 = 0%). Conclusion: Nicotine replacement therapy, behavioral counseling and brief advice appear to be effective in aiding smoking cessation in low- and middle-income countries. There is limited rigorous research on other smoking cessation interventions in these regions.
AB - Aims: To summarize evidence for the efficacy of smoking cessation interventions in low- and middle-income countries (LMICs). Design: Systematic review and meta-analysis of randomized controlled trials. Setting: LMICs as defined by the World Bank. Participants: Adult current cigarette smokers residing in LMICs. Interventions: Behavioral and/or pharmacotherapy smoking cessation interventions. Measurements: PubMed MEDLINE, EMBASE (embase.com), Cochrane Central Register of Controlled Trials (Wiley), PsycINFO (Ebsco), SciELO, WHO Global Index Medicus and Scopus were searched from inception to 4 April 2018. Only studies with at least 6 months of follow-up were included. We used the most rigorous assessment of abstinence reported by each study. Effect sizes were computed from abstracted data. Where possible, a meta-analysis was performed using Mantel–Haenzel random-effect models reporting odds ratios (OR) and 95% confidence intervals (CI). Findings: Twenty-four randomized controlled trials were included. Six investigated the efficacy of pharmacological agents. Four trials that compared nicotine replacement therapy (NRT) to placebo found NRT improved cessation rates (n : NRT 546, control 684, OR = 1.76, 95% CI = 1.30–2.77, P < 0.001, I 2 = 13%). Eight trials found that behavioral counseling was more effective than minimal interventions (e.g. brief advice); n : Counseling 2941, control 2794, OR = 6.87, 95% CI = 4.18–11.29, P < 0.001, I 2 = 67%). There was also evidence of the benefit of brief advice over usual care (n : Brief advice 373, control 355, OR = 2.46, 95% CI = 1.56–3.88, P < 0.001, I 2 = 0%). Conclusion: Nicotine replacement therapy, behavioral counseling and brief advice appear to be effective in aiding smoking cessation in low- and middle-income countries. There is limited rigorous research on other smoking cessation interventions in these regions.
KW - Developing countries
KW - low- and middle-income countries
KW - meta-analysis
KW - smoking cessation
KW - systematic review
KW - tobacco use
UR - http://www.scopus.com/inward/record.url?scp=85059462693&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059462693&partnerID=8YFLogxK
U2 - 10.1111/add.14518
DO - 10.1111/add.14518
M3 - Review article
VL - 114
SP - 620
EP - 635
JO - Addiction
JF - Addiction
SN - 0965-2140
IS - 4
ER -