Advice as a smoking cessation strategy: A systematic review and implications for physical therapists

Abstract

Although identified as a clinical priority, smoking cessation has been addressed minimally in the literature in the context of physical therapy practice. Smoking cessation advice delivered by a health professional can help smokers quit. The salient components of such advice however warranted elucidation to enable physical therapists to integrate this clinical competence into their practices. Therefore, we conducted a systematic review to elucidate the effectiveness of advice by a health professional and its components to optimize smoking cessation instituted in the context of physical therapy practice. Thirty source articles were identified. A random-effects model meta-analysis was used to assess the effectiveness of the advice parameters. Risk ratios (RRs) were used to estimate pooled treatment effects. RRs for brief, intermediate, and intensive advice were 1.74 (95% CI=1.37, 2.22), 1.71 (95% CI=1.39, 2.09), and 1.60 (95% CI=1.13, 2.27), respectively. Self-help materials, follow-up, and interventions based on psychological or motivational frameworks were particularly effective components of intermediate and intensive advice interventions. Advice can be readily integrated into physical therapy practice and used to initiate or support ongoing smoking cessation in clients irrespective of reason for referral. Incorporating smoking cessation as a physical therapy goal is consistent with the contemporary definition of the profession and the mandates of physical therapy professional associations to promote health and wellness, including smoking cessation for both primary health benefit and to minimize secondary effects (e.g., delayed healing and recovery, and medical and surgical complications). Thus, advice is an evidence-based strategy to effect smoking cessation that can be exploited in physical therapy practice. Further research to refine how best to assess smokers and, in turn, individualize brief smoking cessation advice could augment positive smoking cessation outcomes.

Health education strategies used by physical therapists to promote behaviour change in people with lifestyle-related conditions: A systematic review

“…Unequivocal evidence supports that physical activity, optimal nutrition and smoking cessation are essential to address directly the pathoetiology of most cases of chronic lifestyle-related conditions and this knowledge needs to be translated routinely into patient care [3,15]. Despite a substantial gap in the translation of this knowledge into contemporary healthcare practices of health professionals, it is encouraging that people appear more likely to successfully change their diet and exercise patterns after counselling from a health professional, even if seemingly minimal [10,18].…”

Environmental and Genomic Factors as well as Interventions Influencing Smoking Cessation: A Systematic Review of Reviews and a Proposed Working Model

“…Different types of nonpharmacological interventions indicate a substantial improvement in SC: individual counselling (although in contrast with 2 other meta-analyses, Coleman et al [68] did not report any benefit of individual counselling, I² = 68%) [68,81,82], group counselling [82,83], web-based interventions [84,85,86,87], telephone counselling (with pro-active telephone counselling being even more effective than simple telephone counselling) [82,88,89,90,91], motivational interviewing [92,93,94,95], and genetic notification of smoking-related disease risk [96,97]. Other interventions described in the meta-analyses do not demonstrate statistical significant differences.…”

Health behaviour change and lifestyle-related condition prevalence: Comparison of two epochs based on systematic review of the physical therapy literature

“…As a health profession which aspires to focus on health overall, physical therapy is poised to address smoking and the benefits of quitting [34]. Furthermore, exercise can be an effective component of smoking cessation programmes [35] and, as clinical exercise specialists, physical therapists can play a role [36]. Although physical therapists may recognise a responsibility to advise patients to quit smoking, many report being unprepared to counsel and report barriers, e.g., lack of resources and time [36].…”