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Review
. 2022 Aug 23;31(165):220063.
doi: 10.1183/16000617.0063-2022. Print 2022 Sep 30.

Intensive versus short face-to-face smoking cessation interventions: a meta-analysis

Mette Rasmussen  1   2 , Susanne Vahr Lauridsen  3   4 , Bolette Pedersen  3 , Vibeke Backer  5 , Hanne Tønnesen  3   2
Affiliations
Review

Intensive versus short face-to-face smoking cessation interventions: a meta-analysis

Mette Rasmussen et al. Eur Respir Rev. .

Abstract

Objectives: To evaluate the efficacy of intensive smoking cessation interventions (ISCIs) directly compared with shorter interventions (SIs), measured as successful quitting.

Method: Medline, Embase, the Cochrane Library and CINAHL were searched on 15 October 2021. Peer-reviewed randomised controlled trials (RCTs) of adult, daily smokers undergoing an ISCI were included. No setting, time or language restrictions were imposed. Risk of bias and quality of evidence was assessed using the Cochrane tool and Grading of Recommendations, Assessment, Development and Evaluation, respectively. Meta-analyses were conducted using a random-effects model.

Results: 17 550 unique articles were identified and 17 RCTs evaluating 9812 smokers were included. 14 studies were conducted in Europe or the USA. The quality of the evidence was assessed as low or moderate. Continuous abstinence was significantly higher in ISCIs in the long term (risk ratio 2.60, 95% CI 1.71-3.97). Direction and magnitude were similar in the short term; however, they were not statistically significant (risk ratio 2.49, 95% CI: 0.94-6.56). When measured as point prevalence, successful quitting was still statistically significant in favour of ISCIs, but lower (long term: 1.64, 1.08-2.47; short term: 1.68, 1.10-2.56). Sensitivity analysis confirmed the robustness of the results.

Conclusion: ISCIs are highly effective compared to SIs. This important knowledge should be used to avoid additional morbidity and mortality caused by smoking.

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Conflict of interest statement

Conflicts of interests: None of the authors have any conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart of the literature search and study selection. ITT: intention to treat; RCT: randomised controlled trial.
FIGURE 2
FIGURE 2
a–d) Meta-analysis of all studies reporting continuous abstinence and/or point prevalence divided into short- and long-term follow-up. Risk of bias legend: A) random sequence generation (selection bias); B) allocation concealment (selection bias), C) blinding of participants and personnel (performance bias), D) blinding of outcome assessment (detection bias), E) incomplete outcome data (attrition bias), F) selective reporting (reporting bias), G) other bias. CI: confidence interval; M-H: Mantel–Haenszel.
FIGURE 3
FIGURE 3
Funnel plot of the studies included in the point prevalence outcome in the long term. SE: standard error
See this image and copyright information in PMC

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