Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research, 501 Smyth Road, Box 201, Ottawa, Ontario, K1H 8L6, Canada.
Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Syst Rev. 2024 Jul 12;13(1):179. doi: 10.1186/s13643-024-02570-9.
This overview of reviews aims to identify evidence on the benefits (i.e. tobacco use abstinence and reduction in smoking frequency) and harms (i.e. possible adverse events/outcomes) of smoking cessation interventions among adults aged 18 years and older.
We searched Medline, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, the CADTH Health Technology Assessment Database and several other websites for grey literature. Searches were conducted on November 12, 2018, updated on September 24, 2020, with publication years 2008 to 2020. Two reviewers independently performed title-abstract and full-text screening considering pre-determined inclusion criteria. Data extraction and quality assessments were initially completed by two reviewers independently (i.e. 73% of included studies (n = 22)) using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR 2), and the remainder done by one reviewer and verified by another due to resources and feasibility. The application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) was performed by one independent reviewer and verified by another.
A total of 22 Cochrane systematic reviews evaluating the impact of smoking cessation interventions on outcomes such as tobacco use abstinence, reduction in smoking frequency, quality of life and possible adverse events were included. Pharmaceutical (i.e. varenicline, cytisine, nicotine replacement therapy (NRT), bupropion) and behavioural interventions (i.e. physician advice, non-tailored print-based self-help materials, stage-based individual counselling, etc.) showed to have increased smoking cessation; whereas, data for mobile phone-based interventions including text messaging, hypnotherapy, acupuncture, continuous auricular stimulation, laser therapy, electrostimulation, acupressure, St John's wort, S-adenosyl-L-methionine (SAMe), interactive voice response systems and other combination treatments were unclear. Considering harms related to smoking cessation interventions, small/mild harms (i.e. increased palpitations, chest pain, nausea, insomnia, headache) were observed following NRT, varenicline and cytisine use. There were no data on harms related to behavioural therapies (i.e. individual or group counselling self-help materials, internet interventions), combination therapies or other therapies (i.e. laser therapy, electrostimulation, acupressure, St John's wort, SAMe).
Results suggest that pharmacological and behavioural interventions may help the general smoking population quit smoking with observed small/mild harms following NRT or varenicline. Consequently, evidence regarding ideal intervention strategies and the long-term impact of these interventions for preventing smoking was unclear.
PROSPERO CRD42018099691.
本综述旨在确定 18 岁及以上成年人戒烟干预措施的益处（即烟草使用戒除和吸烟频率降低）和危害（即可能的不良事件/结果）的证据。
我们检索了 Medline、Embase、PsycINFO、Cochrane 系统评价数据库、效应摘要数据库、加拿大治疗技术评估署健康技术评估数据库和其他几个灰色文献网站。搜索于 2018 年 11 月 12 日进行，2020 年 9 月 24 日更新，出版年份为 2008 年至 2020 年。两名审查员独立根据预定的纳入标准进行标题-摘要和全文筛选。最初，两名审查员（73%的纳入研究（n=22））使用 A Measurement Tool to Assess Systematic Reviews-2（AMSTAR 2）独立完成数据提取和质量评估，由于资源和可行性的原因，其余部分由一名审查员完成并由另一名审查员验证。应用 Grading of Recommendations Assessment, Development and Evaluation（GRADE）由一名独立审查员进行，并由另一名审查员验证。
共纳入了 22 项评估戒烟干预措施对烟草使用戒除、吸烟频率降低、生活质量和可能的不良事件等结果影响的 Cochrane 系统评价。药物治疗（即伐伦克林、烟碱、尼古丁替代疗法（NRT）、安非他酮）和行为干预（即医生建议、非定制印刷自助材料、基于阶段的个体咨询等）显示可以增加戒烟率；而关于基于手机的干预措施（包括短信、催眠疗法、针灸、持续耳穴刺激、激光疗法、电刺激、穴位按压、贯叶连翘、S-腺苷-L-蛋氨酸（SAMe）、交互式语音应答系统和其他联合治疗）的数据尚不清楚。考虑到与戒烟干预相关的危害，使用 NRT、伐伦克林和烟碱后观察到小/轻度危害（即心悸、胸痛、恶心、失眠、头痛）。没有关于行为治疗（即个体或小组咨询自助材料、互联网干预）、联合治疗或其他治疗（即激光疗法、电刺激、穴位按压、贯叶连翘、SAMe）相关危害的数据。
结果表明，药物和行为干预措施可能有助于一般吸烟人群戒烟，使用 NRT 或伐伦克林后观察到小/轻度危害。因此，关于这些干预措施预防吸烟的理想干预策略和长期影响的证据尚不清楚。
PROSPERO CRD42018099691。
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