Brief opportunistic smoking cessation interventions: a systematic review and meta‐analysis to compare advice to quit and offer of assistance
Abstract
AIMS: This study aimed to assess the effects of opportunistic brief physician advice to stop smoking and offer of assistance on incidence of attempts to stop and quit success in smokers not selected by motivation to quit. METHODS: We included relevant trials from the Cochrane Reviews of physician advice for smoking cessation, nicotine replacement therapy (NRT), varenicline and bupropion. We extracted data on quit attempts and quit success. Estimates were combined using the Mantel-Haentszel method and heterogeneity assessed with the I(2) statistic. Study quality was assessed by method of randomization, allocation concealment and follow-up blind to allocation. RESULTS: Thirteen studies were included. Compared to no intervention, advice to quit on medical grounds increased the frequency of quit attempts [risk ratio (RR) 1.24, 95% confidence interval (CI): 1.16-1.33], but not as much as behavioural support for cessation (RR 2.17, 95% CI 1.52-3.11) or offering NRT (RR 1.68, 95% CI: 1.48-1.89). In a direct comparison, offering assistance generated more quit attempts than giving advice to quit on medical grounds (RR 1.69, 95% CI: 1.24-2.31 for behavioural support and 1.39, 95% CI: 1.25-1.54 for offering medication). There was evidence that medical advice increased the success of quit attempts and inconclusive evidence that offering assistance increased their success. CONCLUSIONS: Physicians may be more effective in promoting attempts to stop smoking by offering assistance to all smokers than by advising smokers to quit and offering assistance only to those who express an interest in doing so.
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Systematic reviews have shown that preventive interventions in the primary care setting can be effective in changing patient behavior, including reducing alcohol consumption, increasing physical activity, smoking cessation, and weight loss.
“Systematic reviews have shown that preventive interventions in the primary care setting can be effective in changing patient behavior, including reducing alcohol consumption [17], increasing physical activity [18], smoking cessation [19], and weight loss [20].”
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Only one of the included guidelines indicated the amount of time to allow for DRR actions.
“Only one guideline indicated the amount of time to allow for DRR actions [19].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [19]
The latter, less frequently performed 3 A's have the greatest impact on healthful behavior change.
“and it is these latter, less frequently performed 3 A’s that have the greatest impact on healthful behavior change.22,47–51”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [50]
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- Authors
- Aveyard, P., Begh, R., Parsons, A., & West, R.
- Affiliations
- University of Birmingham (GB)
- University College London (GB)
- Corresponding author
- Aveyard, Paul
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2012-02-28
- Volume
- 107
- Issue
- 6
- Pages
- 1066-1073
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W1740591447
- Cited by
- 390
- References
- 67
- Citations by year
- 2026: 13 · 2025: 22 · 2024: 20 · 2023: 28 · 2022: 26 · 2021: 30 · 2020: 32 · 2019: 33 · 2018: 38 · 2017: 28 · 2016: 26 · 2015: 29 · 2014: 25 · 2013: 30 · 2012: 10
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Cancer Research UK (14135)
- British Heart Foundation
- Economic and Social Research Council (ES/G007489/1)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- smoking cessation, behavioral support, nicotine replacement therapy, varenicline, bupropion, quit attempts
- MeSH terms
- Smoking Prevention, Behavior Therapy, Counseling, Health Promotion, Humans, Smoking Cessation, Tobacco Use Cessation Devices
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