Effectiveness of smoking cessation interventions for smokers with chronic diseases: A systematic review

Abstract

Aims To systematically summarize seminal studies on the design and effectiveness of smoking cessation interventions targeted at patients with chronic diseases through a critical appraisal of the literature. Design A systematic review. Data Sources This review included literature identified through a search of six databases up to June 2020. Review Methods This review was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. The literature search was limited to English‐language articles on the effectiveness of smoking cessation interventions for smokers who were aged ≥18 years and diagnosed with chronic diseases. Data were extracted using the Cochrane Data collection form for intervention reviews of randomized controlled trials and non‐randomized controlled trials. The articles were subjected to a quality assessment. Results Ten relevant articles were identified. The designs of the interventions were highly heterogeneous, and only six articles reported a significant increase in smoking abstinence among patients with chronic diseases. In the target population, an intervention delivered by healthcare professionals on an intensive schedule was shown to more effectively induce smoking cessation, compared with minimal counselling. However, methodological flaws were identified in most of the included studies. Conclusion The findings of this review suggest that additional efforts are needed to design smoking cessation interventions for patients with chronic diseases and that further examination of the effectiveness and feasibility of these interventions is warranted. Impact What problem did the study address? This review evaluated the effectiveness of smoking cessation interventions targeted at patients with chronic diseases. What were the main findings? An intervention with an intensive schedule that was delivered by healthcare professionals was shown to more effectively induce smoking cessation in patients with chronic diseases, compared with minimal counselling. More attention and resources should be directed towards smokers with no intention to quit, especially those with chronic diseases. There is an urgent need for generic smoking cessation interventions that use novel approaches to address the unique needs of this population and to integrate such evidence‐based interventions into routine care. Where and on whom will the research have impact? The findings of this review may guide nurses, who play a prominent role in raising the issue of smoking cessation with patients, to design appropriate smoking cessation interventions for patients with chronic diseases. The resulting improvements in patients’ health would not only benefit patients themselves but also reduce the burden of chronic diseases on healthcare systems.

A general health promotion approach to helping smokers with non-communicable diseases quit smoking: A pilot randomized controlled trial

“…Most importantly, instant messaging through applications is more flexible, efficient and time-saving than face-to-face meetings, particularly during pandemic, where the delivery of face-to-face health care interventions may not be feasible. Direct comparison with other previous trials may not be applicable owing to differences in types of mobile health intervention used, characteristics of target population and theoretical frameworks for study design ( 35 ). Nonetheless, the results of this study showed a higher odds of biochemically validated smoking abstinence at 6-month follow-up than that in a Cochrane meta-analysis of 12 trials on mobile health intervention for smoking cessation ( 21 ).…”

Helping patients with chronic diseases quit smoking by understanding their risk perception, behaviour, and smoking-related attitudes

“…Continuation of smoking among patients with chronic diseases may also detrimentally affect health and treatment outcomes, increasing the risk of disease progression or recurrence and thus elevating the risk of mortality and reducing the efficacy of treatment [ 7 – 9 ]. The prevalence of smoking ranged from 15% to 26% among patients with chronic disease [ 10 ]. According to the World Health Organization [ 11 ], 14% of all deaths from chronic diseases were attributable to smoking.…”

“…Several studies have indicated that the majority of Hong Kong Chinese with chronic diseases who smoke were in the precontemplation stage (i.e., no intention to quit) [ 19 ]; of these, 68% had cardiovascular disease [ 14 ], 70% had diabetes mellitus [ 16 ], and 73% had cancer [ 15 ]. A recent systematic review involving 10 interventional trials targeting adult smokers with chronic diseases found that the participant selection criteria in most studies excluded unmotivated smokers, indicating that most existing interventions and studies do not include the majority of smokers with chronic diseases [ 10 ]. This finding underscores the critical need for developing and evaluating appropriate smoking cessation interventions to promote smoking cessation targeting this population.…”

Contingency management for smokers with mental health disorders and smoking-sensitive conditions caused or exacerbated by tobacco use: A review of existing studies, intervention parameters, and research priorities.

“…These conditions are associated with heavy smoking patterns characterized by an average of 19–24 cigarettes per day (Gilbody et al, 2019; Schnoll et al, 2004) and severe ND, especially in people with psychiatric disorders (Paik et al, 2019; Wang et al, 2021). These populations also struggle with withdrawal symptoms and exhibit lower cessation rates than the general population, even when evidence-based therapies are delivered (Ho et al, 2021; Secades-Villa et al, 2017). Consequently, it is particularly important to develop effective smoking cessation treatments specifically tailored to these populations (Ho et al, 2021; Prochaska & Benowitz, 2019).…”

“…These populations also struggle with withdrawal symptoms and exhibit lower cessation rates than the general population, even when evidence-based therapies are delivered (Ho et al, 2021; Secades-Villa et al, 2017). Consequently, it is particularly important to develop effective smoking cessation treatments specifically tailored to these populations (Ho et al, 2021; Prochaska & Benowitz, 2019).…”