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Meta-Analysis
. 2019 Oct 29;2019(10):CD012659.
doi: 10.1002/14651858.CD012659.pub2.

Real-time video counselling for smoking cessation

Flora Tzelepis  1   2   3 , Christine L Paul  1 , Christopher M Williams  1   2   3 , Conor Gilligan  1   2 , Tim Regan  1   3 , Justine Daly  3 , Rebecca K Hodder  1   2   3 , Emma Byrnes  1   3 , Judith Byaruhanga  1 , Tameka McFadyen  1   3 , John Wiggers  1   2   3
Affiliations
Meta-Analysis

Real-time video counselling for smoking cessation

Flora Tzelepis et al. Cochrane Database Syst Rev. .

Abstract

Background: Real-time video communication software such as Skype and FaceTime transmits live video and audio over the Internet, allowing counsellors to provide support to help people quit smoking. There are more than four billion Internet users worldwide, and Internet users can download free video communication software, rendering a video counselling approach both feasible and scalable for helping people to quit smoking.

Objectives: To assess the effectiveness of real-time video counselling delivered individually or to a group in increasing smoking cessation, quit attempts, intervention adherence, satisfaction and therapeutic alliance, and to provide an economic evaluation regarding real-time video counselling.

Search methods: We searched the Cochrane Tobacco Addiction Group Specialised Register, CENTRAL, MEDLINE, PubMed, PsycINFO and Embase to identify eligible studies on 13 August 2019. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov to identify ongoing trials registered by 13 August 2019. We checked the reference lists of included articles and contacted smoking cessation researchers for any additional studies.

Selection criteria: We included randomised controlled trials (RCTs), randomised trials, cluster RCTs or cluster randomised trials of real-time video counselling for current tobacco smokers from any setting that measured smoking cessation at least six months following baseline. The real-time video counselling intervention could be compared with a no intervention control group or another smoking cessation intervention, or both.

Data collection and analysis: Two authors independently extracted data from included trials, assessed the risk of bias and rated the certainty of the evidence using the GRADE approach. We performed a random-effects meta-analysis for the primary outcome of smoking cessation, using the most stringent measure of smoking cessation measured at the longest follow-up. Analysis was based on the intention-to-treat principle. We considered participants with missing data at follow-up for the primary outcome of smoking cessation to be smokers.

Main results: We included two randomised trials with 615 participants. Both studies delivered real-time video counselling for smoking cessation individually, compared with telephone counselling. We judged one study at unclear risk of bias and one study at high risk of bias. There was no statistically significant treatment effect for smoking cessation (using the strictest definition and longest follow-up) across the two included studies when real-time video counselling was compared to telephone counselling (risk ratio (RR) 2.15, 95% confidence interval (CI) 0.38 to 12.04; 2 studies, 608 participants; I2 = 66%). We judged the overall certainty of the evidence for smoking cessation as very low due to methodological limitations, imprecision in the effect estimate reflected by the wide 95% CIs and inconsistency of cessation rates. There were no significant differences between real-time video counselling and telephone counselling reported for number of quit attempts among people who continued to smoke (mean difference (MD) 0.50, 95% CI -0.60 to 1.60; 1 study, 499 participants), mean number of counselling sessions completed (MD -0.20, 95% CI -0.45 to 0.05; 1 study, 566 participants), completion of all sessions (RR 1.13, 95% CI 0.71 to 1.79; 1 study, 43 participants) or therapeutic alliance (MD 1.13, 95% CI -0.24 to 2.50; 1 study, 398 participants). Participants in the video counselling arm were more likely than their telephone counselling counterparts to recommend the programme to a friend or family member (RR 1.06, 95% CI 1.01 to 1.11; 1 study, 398 participants); however, there were no between-group differences on satisfaction score (MD 0.70, 95% CI -1.16 to 2.56; 1 study, 29 participants).

Authors' conclusions: There is very little evidence about the effectiveness of real-time video counselling for smoking cessation. The existing research does not suggest a difference between video counselling and telephone counselling for assisting people to quit smoking. However, given the very low GRADE rating due to methodological limitations in the design, imprecision of the effect estimate and inconsistency of cessation rates, the smoking cessation results should be interpreted cautiously. High-quality randomised trials comparing real-time video counselling to telephone counselling are needed to increase the confidence of the effect estimate. Furthermore, there is currently no evidence comparing real-time video counselling to a control group. Such research is needed to determine whether video counselling increases smoking cessation.

PubMed Disclaimer

Conflict of interest statement

FT: none.

CLP: none.

CMW: none.

CG: none.

TR: none.

JD: none.

RKH: none.

EB: none.

JB: none.

TM: none.

JW: none.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Smoking cessation, real‐time video counselling versus telephone counselling, Outcome 1 Smoking cessation (strictest definition and longest follow‐up).
2.1
2.1. Analysis
Comparison 2 Quit attempts, real‐time video counselling versus telephone counselling, Outcome 1 Number of quit attempts.
3.1
3.1. Analysis
Comparison 3 Intervention adherence, real‐time video counselling versus telephone counselling, Outcome 1 Number of sessions completed.
3.2
3.2. Analysis
Comparison 3 Intervention adherence, real‐time video counselling versus telephone counselling, Outcome 2 Completed all sessions.
4.1
4.1. Analysis
Comparison 4 Satisfaction, real‐time video counselling versus telephone counselling, Outcome 1 Recommend to friend or family member.
4.2
4.2. Analysis
Comparison 4 Satisfaction, real‐time video counselling versus telephone counselling, Outcome 2 Satisfaction score.
5.1
5.1. Analysis
Comparison 5 Therapeutic alliance, real‐time video counselling versus telephone counselling, Outcome 1 Therapeutic alliance.
See this image and copyright information in PMC

Update of

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Publication types