Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta-analysis

Nicola Black^{1

2}, Maarten C Eisma^{1

3}, Wolfgang Viechtbauer⁴, Marie Johnston¹, Robert West⁵, Jamie Hartmann-Boyce⁶, Susan Michie⁷, Marijn de Bruin^{1

8}

Affiliations

¹ Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, UK.
² National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
³ Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.
⁴ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
⁵ Department of Behavioral Science and Health, University College London, London, UK.
⁶ Nuffield Department of Primary Care Health Sciences, Oxford, UK.
⁷ Centre for behavior Change, University College London, Gower Street, London, WC1E 6BT, UK.
⁸ Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.

PMID: 32043675
PMCID: PMC7496125
DOI: 10.1111/add.14969

Meta-Analysis

Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta-analysis

Nicola Black et al. Addiction. 2020 Sep.

. 2020 Sep;115(9):1607-1617.

doi: 10.1111/add.14969. Epub 2020 Feb 11.

Authors

Nicola Black^{1

2}, Maarten C Eisma^{1

3}, Wolfgang Viechtbauer⁴, Marie Johnston¹, Robert West⁵, Jamie Hartmann-Boyce⁶, Susan Michie⁷, Marijn de Bruin^{1

8}

Affiliations

¹ Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, UK.
² National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
³ Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.
⁴ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
⁵ Department of Behavioral Science and Health, University College London, London, UK.
⁶ Nuffield Department of Primary Care Health Sciences, Oxford, UK.
⁷ Centre for behavior Change, University College London, Gower Street, London, WC1E 6BT, UK.
⁸ Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.

PMID: 32043675
PMCID: PMC7496125
DOI: 10.1111/add.14969

Abstract

Aims: To examine variability and effectiveness of interventions provided to comparator (control) groups in smoking cessation trials.

Methods: Systematic review with meta-analysis of randomized controlled trials (RCTs) of behavioral interventions for smoking cessation, with or without stop-smoking medication. We searched the Cochrane Tobacco Addiction Group Specialized Register for RCTs with objective outcomes measured at ≥ 6 months. Study authors were contacted to obtain comprehensive descriptions of their comparator interventions. Meta-regression analyses examined the relationships of smoking cessation rates with stop-smoking medication and behavior change techniques.

Results: One hundred and four of 142 eligible comparator groups (n = 23 706) had complete data and were included in analyses. There was considerable variability in the number of behavior change techniques delivered [mean = 15.97, standard deviation (SD) = 13.54, range = 0-45] and the provision of smoking cessation medication (43% of groups received medication) throughout and within categories of comparator groups (e.g. usual care, brief advice). Higher smoking cessation rates were predicted by provision of medication [B = 0.334, 95% confidence interval (CI) = 0.030-0.638, P = 0.031] and number of behavior change techniques included (B = 0.020, 95% CI = 0.008-0.032, P < 0.001). Modelled cessation rates in comparator groups that received the most intensive support were 15 percentage points higher than those that received the least (23 versus 8%).

Conclusions: Interventions delivered to comparator groups in smoking cessation randomized controlled trials vary considerably in content, and cessation rates are strongly predicted by stop-smoking medication and number of behavior change techniques delivered.

Keywords: Behavior change techniques; comparator group; control group; meta-analysis; meta-regression; smoking cessation; systematic review.

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Figures

**Figure 1**
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram. BCTs = behavior change techniques

**Figure 2**
Predicted smoking cessation rates across the observed range of (a) total behavior change techniques (BCTs) and (b) personalized, person‐delivered BCTs. Dotted lines represent 95% confidence intervals. Estimated smoking cessation rates are computed at 6‐month follow‐up, non‐cotinine verified, point prevalence abstinence and mean levels of age and nicotine dependence. [Colour figure can be viewed at wileyonlinelibrary.com]

See this image and copyright information in PMC

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Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta-analysis

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Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta-analysis

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