Behavioural interventions for smoking cessation: an overview and network meta-analysis

Hartmann‐Boyce, Jamie; Fanshawe, Thomas; Lindson, Nicola; Livingstone‐Banks, Jonathan; Ordóñez‐Mena, José M.; Aveyard, Paul

doi:10.1002/14651858.cd013229

Cited by 54 publications

(66 citation statements)

References 32 publications

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“…When we undertook a meta-analysis, we found that bespoke person-based smoking cessation interventions for people with SMI were more effective than usual care across all time-points. This is in line with previous reviews suggesting that smoking cessation interventions are effective in people with mental health problems (but not exclusively SMI) [13] and the general population [40]. The largest of the three trials (n = 526) in this meta-analysis was at low risk of bias (there were some concerns for the other two), meaning that we are reasonably confident in our conclusion.…”

Section: Discussionsupporting

confidence: 90%

A systematic review of behavioural smoking cessation interventions for people with severe mental ill health—what works?

et al. 2021

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Background and Aims: People with severe mental ill health smoke more and suffer greater smoking-related morbidity and mortality. Little is known about the effectiveness of behavioural interventions for smoking cessation in this group. This review evaluated randomized controlled trial evidence to measure the effectiveness of behavioural smoking cessation interventions (both digital and non-digital) in people with severe mental ill health. Design: Systematic review and random-effects meta-analysis. We searched between inception and January 2020 in Medline, EMBASE, PsycINFO, CINAHL, Health Management Information Consortium and CENTRAL databases. Setting and participants: Randomized controlled trials (RCTs) assessing the effects of behavioural smoking cessation and reduction interventions in adults with severe mental ill health, conducted in any country, in either in-patient or community settings and published in English.Measurements: The primary outcome was biochemically verified smoking cessation.Smoking reduction and changes in mental health symptoms and body mass index (BMI) were included as secondary outcomes. Narrative data synthesis and meta-analysis were conducted and the quality of included studies was appraised using the risk of bias 2 (RoB2) tool. Findings: We included 12 individual studies (16 articles) involving 1861 participants. The first meta-analysis (three studies, 921 participants) demonstrated effectiveness of bespoke face-to-face interventions compared with usual care across all time-points [medium-term: relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.38-3.81; long-term: RR = 1.58, 95% CI = 1.09-2.30]. The second (three studies, 275 participants) did not demonstrate any difference in effectiveness of bespoke digital on-line interventions compared with standard digital on-line interventions (medium-term: RR = 0.87, 95% CI = 0.17-4.46). A narrative overview revealed mixed results when comparing bespoke face-to-face interventions with other active interventions. The methodological quality of studies was mixed, with the majority having some concerns mainly around risk of selective reporting. Panagiotis Spanakis and Emily Peckham joint first authors.

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Section: Discussionsupporting

confidence: 90%

A systematic review of behavioural smoking cessation interventions for people with severe mental ill health—what works?

et al. 2021

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“…Network meta-analyses have gained great importance in therapeutic research wherever a large number of CTs on different drugs are to be correlated. [5][6][7][8][9] This is currently particularly true in psoriasis, where a large number of approved drugs means that it is no longer possible to conduct complete clinical research with direct comparisons. Multiple comparisons are therefore used via bridge operators to create a comparable data situation.…”

Section: Discussionmentioning

confidence: 99%

“…Also, interventions other than drug treatments were investigated, such as exercise in Alzheimer's disease 8 . A rising number of NMAs has also been used in current Cochrane reviews 9 . However, a surprisingly low number of meta‐studies investigating the quality and outcomes of different NMAs for one indication and type of intervention has been published 10,11 …”

Section: Introductionmentioning

confidence: 99%

“…8 A rising number of NMAs has also been used in current Cochrane reviews. 9 However, a surprisingly low number of meta-studies investigating the quality and outcomes of different NMAs for one indication and type of intervention has been published. 10,11 Also for the drug treatment of psoriasis, a large number of NMA have been conducted, which differ in the spectrum of drugs used, the studies included and the results gained.…”

Section: Introductionmentioning

confidence: 99%

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Network meta‐analyses in psoriasis: overview and critical discussion

Augustin

López

Reich

2021

Acad Dermatol Venereol

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Network meta‐analyses (NMAs) increasingly assist in treatment decisions in disease areas such as psoriasis, where data from multiple clinical trials (CTs) on a growing number of different drugs become available. This study aimed to characterize NMAs published in psoriasis. A systematic literature search in PubMed was conducted using a structured search protocol based on the PRISMA criteria. Twenty‐seven NMAs were identified, including an average of 43 CTs per NMA. Only eight of 27 NMAs (29.6%) were documented in the PROSPERO registry and only 17 (63%) reported following the PRISMA criteria. The mean number of patients per NMA was 19 624 (range: 6113–51 749). Across all NMAs, the drugs most frequently included were ustekinumab (n = 27 NMAs), followed by adalimumab (n = 25), infliximab and etanercept (n = 24 each). In all n = 27 NMAs, placebo comparisons and in n = 25, comparisons with active controls were used for bridging. Effect estimates were performed in all cases, SUCRA in 14. Most frequently used outcomes were Psoriasis Area and Severity Index (PASI) 75 (n = 25) and PASI 90 (n = 24), and Dermatology Life Quality Index (n = 10). NMAs mostly measured induction efficacy (weeks 10–16, n = 25) but rarely long‐term outcomes (weeks 48–56, n = 4). Sensitivity analyses were performed in n = 17 (63%) of the studies. Main results varied considerably between studies and depended on the year of publication and thus the number of available drugs and studies. However, the concordance between NMA efficacy rankings based on PASI 75 was high. Although a large number of NMAs have been published on psoriasis showing highly comparable results on efficacy, no sufficient information on the quality criteria was reported, and PROSPERO registry criteria were not followed. This argues in favour of greater standardization of NMA methodology and reporting.

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“…In 2019 and 2020, CTAG published six new reviews and updated 15 previously published reviews Many of these reviews were updated as part of a National Institute for Health Research (NIHR)‐funded Cochrane programme grant in order to feed into an overview of reviews with a component network meta‐analysis of behavioural interventions for smoking cessation [11]. Others were updated at the request of NICE to inform guideline updates [12–14].…”

Section: Resultsmentioning

confidence: 99%

Effects of interventions to combat tobacco addiction: Cochrane update of 2019 and 2020 reviews

et al. 2021

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Aims To summarize evidence on tobacco addiction interventions published by the Cochrane Tobacco Addiction Group (CTAG) from 2019 to 2020. Methods Narrative summary of all new and updated Cochrane Reviews published by CTAG in 2019 and 2020, outlining key results and promising avenues for future research. Results CTAG published six new reviews and updated 15 reviews. There is high‐certainty evidence that combining fast‐acting nicotine replacement therapy (NRT) with transdermal patches helped more people to quit than single‐form NRT [risk ratio (RR) = 1.25, 95% confidence interval (CI) = 1.15–1.36, 14 studies, n = 11 356; I2 = 4%] and moderate‐certainty evidence that using NRT before quitting can increase quit rates more than using NRT from quit day onwards (RR = 1.25, 95% CI = 1.08–1.44, nine studies, n = 4395; I2 = 0%). Reducing smoking in order to quit completely results in similar quit rates to abrupt quitting (RR = 1.01, 95% CI= 0.87–1.17; I2 = 29%; 22 studies, n = 9219; moderate‐certainty). Electronic cigarettes may help more people quit than NRT (RR = 1.53, 95% CI = 1.21–1.93; I2 = 0%; four studies, n = 1924; moderate certainty), nicotine‐free electronic cigarettes (RR = 1.94, 95% CI = 1.21–3.13; I2 = 0%; five studies, n = 1447; moderate‐certainty) and behavioural/no support (RR = 2.61, 95% CI = 1.44–4.74; I2 = 0%; six studies, n = 2886; very low‐certainty). Varenicline may help prevent relapse in abstainers (RR = 1.23, 95% CI = 1.08–1.41; I2 = 82%; 11 studies, n = 1297; moderate‐certainty), but behavioural support did not prevent relapse (RR = 0.98, 95% CI = 0.87–1.11; I2 = 52%; 11 studies, n = 5523; moderate‐certainty). Financial incentives increased quit rates in the general population (RR = 1.49, 95% CI = 1.28–1.73; I2 = 33%; 30 studies, adjusted n = 20 097; high‐certainty) and during pregnancy (RR = 2.38, 95% CI = 1.54–3.69; I2 = 41%; nine studies, n = 2273; moderate‐certainty). This overview also provides detail on a wider range of interventions. Conclusions There is high certainty that using nicotine replacement therapy from quit day increases smoking abstinence and no further research is required. Evidence is less certain that nicotine replacement increases abstinence when used in higher doses tailored to particular groups of smokers or use prior to quit day, and further research would be helpful. There is moderate‐certainty evidence to support the use of e‐cigarettes as cessation aids, but research on their role in preventing relapse would be particularly helpful.

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Behavioural interventions for smoking cessation: an overview and network meta-analysis

Abstract: Behavioural interventions for smoking cessation: an overview and network meta-analysis.

Cited by 54 publications

References 32 publications

A systematic review of behavioural smoking cessation interventions for people with severe mental ill health—what works?

A systematic review of behavioural smoking cessation interventions for people with severe mental ill health—what works?

Network meta‐analyses in psoriasis: overview and critical discussion

Effects of interventions to combat tobacco addiction: Cochrane update of 2019 and 2020 reviews

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