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
AU - O'Dwyer, Linda Catherine
AU - Jordan, Neil
AU - Hitsman, Brian
AU - Bilaver, Lucy Ann
AU - McHugh, Megan Colleen
AU - Murphy, Robert
N1 - Funding Information:
This work was supported by National Institute of Health (NIH) Fogarty Internation Center ‘Northwestern and Jos University Research Training Program in HIV and Malignancies’ grant (no. D43TW009575). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH Fogarty International Center. We acknowledge the contribution of Elizabeth Christian, who helped to edit the manuscript.
Funding Information:
This work was supported by National Institute of Health (NIH) Fogarty Internation Center ?Northwestern and Jos University Research Training Program in HIV and Malignancies? grant (no. D43TW009575). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH Fogarty International Center. We acknowledge the contribution of Elizabeth Christian, who helped to edit the manuscript.
Publisher Copyright:
© 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
PY - 2019/4
Y1 - 2019/4
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
C2 - 30506845
AN - SCOPUS:85059462693
VL - 114
SP - 620
EP - 635
JO - Addiction
JF - Addiction
SN - 0965-2140
IS - 4
ER -
