A systematic narrative review of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups (2010-2017)

Abstract

Tobacco remains the key modifiable risk factor for the development of a number of diseases, including cardiovascular disease, cerebrovascular disease, lower respiratory infections, chronic obstructive pulmonary disease, tuberculosis and cancer. Among priority populations, smoking prevalence remains high, smokers tend to relapse more often and earlier and fewer are able to sustain quit attempts. This systematic review provides an update on the literature. Areas covered: Twenty-four randomized controlled trials published from 2010-2017, in English language, were identified after searching on Medline, Ovid, Embase and PsycINFO databases. Studies reported on the effectiveness of smoking cessation interventions among six disadvantaged groups known to have high smoking rates: (i) homeless, (ii) prisoners, (iii) indigenous populations, (iv) at-risk youth, (v) people with low income, and (vi) those with a mental illness. Narrative review and assessment of methodological quality of included papers was undertaken. Expert commentary: There is a growing evidence base of methodologically robust studies evaluating a variety of behavioural smoking cessation interventions for priority populations. Multi-component interventions and those examining behavioural interventions incorporating mindfulness training, financial incentives, motivational interviewing and extended telephone-delivered counseling may be effective in the short-term, particularly for smokers on low incomes and people with a mental illness.

Smoking cessation intervention delivered by social service organisations for a diverse population of Australian disadvantaged smokers: A pragmatic randomised controlled trial

“…This trial is similar to previous trials with homogeneous groups of disadvantaged smokers (such as people with a mental illness, Indigenous Australians and prisoners) which have found low cessation rates and null outcomes for the behavioural and pharmacotherapy interventions. 4,5 The body of evidence emerging implies that these smokers find it difficult to quit, even when provided with current best practice smoking cessation aids. 4,5 The current intervention was evidence based with brief advice, behavioural counselling and BCTs, offer of combination NRT, social support and follow-up.…”

“…4,5 The body of evidence emerging implies that these smokers find it difficult to quit, even when provided with current best practice smoking cessation aids. 4,5 The current intervention was evidence based with brief advice, behavioural counselling and BCTs, offer of combination NRT, social support and follow-up. One obvious explanation for the lack of effect may be low adherence to the intervention.…”

“…Two systematic reviews of smoking cessation interventions for six disadvantaged groups known to have high smoking rates in high-income countries suggest that multicomponent interventions incorporating behavioural counselling either face-to-face or via telephone, motivational interviewing, and NRT hold the greatest promise of successfully achieving abstinence amongst some disadvantaged groups but not all. 4,5 Delivering comprehensive smoking cessation interventions to smokers who experience disadvantage is challenging as these smokers are often hard-to-reach and as a result sample sizes are small. [4][5][6] In high-income countries including the UK, US and Australia, community social service organisations (CSSO) provide support to the most socially disadvantaged groups 7 with high smoking rates.…”

“…4,5 Delivering comprehensive smoking cessation interventions to smokers who experience disadvantage is challenging as these smokers are often hard-to-reach and as a result sample sizes are small. [4][5][6] In high-income countries including the UK, US and Australia, community social service organisations (CSSO) provide support to the most socially disadvantaged groups 7 with high smoking rates. 8 Small pilot smoking cessation trials suggest that the CSSO setting might be acceptable and feasible, 8,9 however, the effectiveness of this approach has not been evaluated in an adequately powered trial.…”

Well-being and mental health interventions for Indigenous people in prison: systematic review

“…[51][52][53][54] Existing reviews of mental health interventions for prisoners or community offenders typically focus on the general population rather than on Indigenous or First Nations people, [55][56][57][58][59][60][61][62] and other reviews of interventions for vulnerable populations may include some Indigenous people or prisoners, but do not focus on Indigenous prisoners. [63][64][65][66] Only one Indigenous-specific review on prisoners was identified, but that focused on prisoners' needs when transitioning back to the community, rather than on interventions for Indigenous prisoners more generally. 55…”