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Thorax 55:987-999 doi:10.1136/thorax.55.12.987
  • Smoking cessation update

Smoking cessation guidelines for health professionals: an update

Table 1

Incremental effects of smoking cessation interventions on abstinence for six months or longer

Intervention Target population Effect size1-a 95% confidence interval1-b
Brief opportunistic advice from a physician to stop Smokers attending GP surgeries or outpatient clinics 2% 1% to 3%
Face to face intensive behavioural support from a specialist1-c Moderate to heavy smokers seeking help with stopping 7% 3% to 10%
Face to face intensive behavioural support from a specialist Pregnant smokers 7% 5% to 9%
Face to face intensive behavioural support from a specialist1-d Smokers admitted to hospital 4% 0% to 8%
Proactive telephone counselling1-e Smokers wanting help with stopping but not receiving face to face support 2% 1% to 4%
Written self-help materials Smokers seeking help and not receiving other support 1% 0% to 2%
Nicotine gum Moderate to heavy smokers receiving limited behavioural support1-f 5% 4% to 6%
Nicotine gum Moderate to heavy smokers receiving intensivebehavioural support 8% 6% to 10%
Nicotine transdermal patch Moderate to heavy smokers receivinglimited behavioural support 5% 4%-7%
Nicotine transdermal patch Moderate to heavy smokers receiving intensivebehavioural support 6% 5% to 8%
Nicotine nasal spray Moderate to heavy smokers receivingintensive behavioural support 12% 7% to 17%
Nicotine inhalator Moderate to heavy smokers receivingintensive behavioural support 8% 4% to 12%
Nicotine sublingual tablet Moderate to heavy smokers receiving intensive behavioural support 8% 1% to 14%
Bupropion (300 mg/day sustained release) Moderate to heavy smokers receivingintensive behavioural support 9% 5% to 14%
Intensive behavioural support plus NRT or bupropion1-g Moderate to heavy smokers seeking help from a smokers' clinic 13–19%
  • 1-a Difference in >6 month abstinence rate between intervention and control/placebo in the studies reported; data from Cochrane meta-analyses unless otherwise stated.

  • 1-b The range within which one can be 95% confident that the true underlying value lies.

  • 1-c Efficacy figures based on subset of studies from general population with biochemical verification.

  • 1-d No Cochrane review available, data from USDHHS meta-analysis.6

  • 1-e No Cochrane review available, data from USDHHS meta-analysis.6

  • 1-f The term “limited behavioural support” refers to brief sessions required primarily for collecting data. Following the Cochrane definition, “intensive” behavioural support was defined as an initial session of more than 30 minutes, or an initial session of less than 30 minutes plus more than two subsequent visits.

  • 1-g Expected effect combining effect of medication with effect of behavioural support.


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