Sultana Sanchita, Inungu Joseph, Jahanfar Shayesteh
Public Health Epidemiology, Washtenaw County Health Department, Ypsilanti, MI 48198, USA.
School of Health Sciences, Central Michigan University, Mount Pleasant, MI 48859, USA.
Int J Environ Res Public Health. 2025 May 23;22(6):825. doi: 10.3390/ijerph22060825.
Tobacco use is responsible for eight million preventable deaths annually, making it a major modifiable risk factor for chronic conditions such as cardiovascular diseases, respiratory illnesses, and over 20 types of cancers.
This study aimed to systematically review the barriers and facilitators of tobacco cessation interventions at both the population and healthcare system levels in the U.S. Understanding these determinants is critical for narrowing health disparities, optimizing resource allocation, and ultimately, enhancing tobacco cessation success rates across all demographic groups.
A comprehensive literature search was conducted across the PubMed, Embase, and Web of Science databases, guided by the population, intervention, comparison, and outcome framework and quality assessment guided by PRISMA guidelines. Data extraction focused on study characteristics, intervention types, barriers, facilitators, and cessation outcomes at both the population and health system levels. The random effects forest plots were graphed to estimate pooled effect sizes for both medical and non-medical interventions.
A total of 35 studies met the inclusion criteria from an initial pool of 1555 identified records. Socioeconomic disadvantages, digital inequities, and low motivation constitute primary barriers at the individual level, while systemic factors such as healthcare access limitations, inadequate provider engagement, and lack of financial support further hinder cessation efforts. Financial incentives, culturally tailored interventions, and digital engagement strategies significantly improve tobacco cessation outcomes.
as identified by the study, tailored interventions, the expansion of health coverage policies to include intervention, digital solutions, and healthcare resource workforce training will help improve tobacco cessation intervention outcomes.
烟草使用每年导致800万人死亡，这些死亡本可预防，这使其成为心血管疾病、呼吸系统疾病以及20多种癌症等慢性病的主要可改变风险因素。
本研究旨在系统回顾美国在人群和医疗系统层面戒烟干预措施的障碍和促进因素。了解这些决定因素对于缩小健康差距、优化资源分配以及最终提高所有人口群体的戒烟成功率至关重要。
在人口、干预措施、对照和结果框架的指导下，对PubMed、Embase和科学网数据库进行了全面的文献检索，并按照PRISMA指南进行质量评估。数据提取重点关注人群和卫生系统层面的研究特征、干预类型、障碍、促进因素和戒烟结果。绘制随机效应森林图以估计医疗和非医疗干预措施的合并效应大小。
从最初识别出的1555条记录中，共有35项研究符合纳入标准。社会经济劣势、数字不平等和动力不足是个体层面的主要障碍，而医疗服务可及性受限、医疗服务提供者参与不足和缺乏财政支持等系统性因素进一步阻碍了戒烟努力。经济激励措施、文化定制干预措施和数字参与策略显著改善了戒烟结果。
正如该研究所确定的，定制干预措施、扩大健康覆盖政策以纳入干预措施、数字解决方案以及医疗资源劳动力培训将有助于改善戒烟干预结果。
