Combined pharmacotherapy and behavioural interventions for smoking cessation

Abstract

BackgroundBoth behavioural support (including brief advice and counselling) and pharmacotherapies (including nicotine replacement therapy (NRT), varenicline and bupropion) are effective in helping people to stop smoking. Combining both treatment approaches is recommended where possible, but the size of the treatment effect with different combinations and in different settings and populations is unclear. ObjectivesTo assess the effect of combining behavioural support and medication to aid smoking cessation, compared to a minimal intervention or usual care, and to identify whether there are different effects depending on characteristics of the treatment setting, intervention, population treated, or take-up of treatment. Search methodsWe searched the Cochrane Tobacco Addiction Group Specialised Register in July 2015 for records with any mention of pharmacotherapy, including any type of NRT, bupropion, nortriptyline or varenicline. Selection criteriaRandomized or quasi-randomized controlled trials evaluating combinations of pharmacotherapy and behavioural support for smoking cessation, compared to a control receiving usual care or brief advice or less intensive behavioural support. We excluded trials recruiting only pregnant women, trials recruiting only adolescents, and trials with less than six months follow-up.

Should we recommend e-cigarettes to help smokers quit?

“…NRT is most effective when it is prescribed and combined with behavioural support 8. Observational evidence indicates the same may be true for e-cigarettes 9.…”

Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD

“…Pharmacological options are nicotine replacement therapy (NRT), varenicline and bupropion, and counseling includes motivational interviewing and behavioral support performed as individual or group therapy. In a recent meta-analysis the combination of counseling and pharmacological therapy was most successful for smoking cessation compared with a minimal intervention or usual care [9]. According to the international recommendations Global initiative on Obstructive Lung Disease (GOLD) and Global Initiative for Asthma (GINA), smoking cessation is of great importance.…”

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

“…There are about one billion smokers in the world and six million people die each year from tobacco use 3,4 . Evidence from the tobacco control program suggests that pharmacological, psychological and behavioural assistance are key to achieving smoking cessation, as only three percent of the smokers manage to quit without the help of intervention 5 . The search for personalised behavioural intervention along with the pharmacological treatment of addiction is inevitable as this combination produces large effect size for abstinence rate of more than 6 months.…”