Cited by 9Smoking Behavior and CessationMindfulness and Compassion InterventionsSubstance Abuse Treatment and Outcomes

Immediate, Short-term, Medium-term, and Long-term effects of Acceptance and Commitment Therapy for Smoking Cessation: A Systematic Review and Meta-Analysis

Kwan, Yu Kai, Lau, Ying, Ang, Wen Wei, Lau, Siew Tiang·2024·Nicotine and Tobacco Research

Abstract

Introduction: Acceptance and commitment therapy (ACT) is increasingly being studied as a treatment for smoking cessation. However, its immediate, short-, and long-term effects have rarely been reviewed. Methods: This systematic review aimed to evaluate the effectiveness of immediate, short-, medium-, and long-term smoking cessation rates in ACT and comparators at less than 3-month, 3 to 4-month, 6-, and 12-month follow-ups. Randomized controlled trials (RCTs) were searched in eight databases until April 20, 2023. We assessed the quality of RCTs and the certainty of evidence of outcomes. Results: Nineteen RCTs involving 7885 smokers across six countries were included. The majority (72.81%) of RCTs were graded as low risk across six domains. For complete-case outcomes, meta-analyses were conducted, and the results revealed a significant effect in favor of ACT [risk ratio: 1.70–1.80 at <3-month, 3 to 4-month, and 6 months follow-up] compared with comparators. For outcomes using missing data management, meta-analyses found an overall effect in favor of ACT, but a significant effect was found at 3 to 4-months only. However, 12-month follow-ups revealed no significant reduction in smoking cessation for both outcomes. Moderate and substantial heterogeneities were found among four meta-analyses that may lead to inaccurate estimates of effects. The certainty of evidence of all outcomes was rated as low and very low. Conclusion: ACT may be an effective intervention for smoking cessation with immediate, short-term, and medium-term effects. Caution must be applied in the interpretation of the results due to the limited trials and low certainty of evidence. Implication: ACT can be implemented adjuvant to the usual treatment for smoking cessation. Additional RCTs with follow-up data using biochemically verified measures in non-US countries are warranted.

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Crossref · 10.1093/ntr/ntad145

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Authors
Kwan, Y. K., Lau, Y., Ang, W. W., & Lau, S. T.
Affiliations
  • National University of Singapore (SG)
  • Chinese University of Hong Kong (HK)
Corresponding author
Lau, Siew Tiang
Venue
Nicotine and Tobacco Research
Published
2023-08-14
Volume
26
Issue
1
Pages
12-22
ISSN
  • 1462-2203 (ISSN-L)
  • 1469-994X
OpenAlex
W4385812220
Cited by
9
References
72
Citations by year
2026: 1 · 2025: 5 · 2024: 3
FWCI
0.32
Type
journal article
Language
en
Open access
closed
Locations
  • Nicotine & Tobacco Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
acceptance and commitment therapy, smoking cessation, smoking cessation rates, long-term effects, short-term effects, tobacco dependence treatment
MeSH terms
Humans, Smoking Cessation, Tobacco Use Cessation Devices, Acceptance and Commitment Therapy

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