Covariates of success in quitting smoking in the community and secondary acute or mental health care services: a rapid systematic review

Abstract

Introduction Tobacco smokers contacting secondary healthcare services in the United Kingdom (UK) are increasingly being offered support to quit smoking, but there are person and setting-related variables that could moderate their success in quitting smoking. This rapid literature review aims to identify a comprehensive set of variables associated with quitting success. Methods Systematic searches of five electronic databases identified published studies that investigated the success of attempts to quit smoking. Studies eligible for inclusion investigated quitting success in one of three contexts: (a) the general population in the UK; (b) people with a mental health condition; (c) quit attempts initiated within a secondary care setting. Data related to the statistical analysis for all covariates of quitting success were extracted from included papers, then synthesised to identify covariates with a statistically significant (i.e., p-value <0.05) association. Results The review identified 29 relevant studies and 14 data fields, which we grouped into four categories: demographics (age; sex; ethnicity; socio-economic conditions; relationship status, cohabitation and social network), individual health status and healthcare setting (physical health, mental health), tobacco smoking variables (current tobacco consumption, smoking history, nicotine dependence; motivation to quit; quitting history), and intervention characteristics (reduction in amount smoked prior to quitting, the nature of behavioural support, tobacco dependence treatment duration, pharmacological aids). Conclusions Fourteen data fields were identified as having a statistically significant relationship with smoking quit success. These data fields should be considered for inclusion in datasets and statistical analysis plans for evaluating the quitting outcomes of smoking cessation interventions initiated in secondary care contexts in the UK.

Covariates of success in quitting smoking: a systematic review of studies from 2008 to 2021 conducted to inform the statistical analyses of quitting outcomes of a hospital-based tobacco dependence treatment service in the United Kingdom

“…From 2,499 retrieved records, 29 studies were included in the synthesis ( Figure 1 ), representing 21 studies relating to the UK general population context, six studies relating to mental health in the UK or Canada, and two studies relating to secondary care in the UK or Canada. A list of excluded studies with reasons is available in Table S1 in Supplement 2 of the Extended data 14 .…”

“…The characteristics of the included studies and participants’ characteristics are summarised in Table S2 and Table S3 in Supplement 2 of the Extended data 14 . Most studies had prospective, cross-sectional or retrospective designs; three studies were randomised controlled trials (RCTs).…”

“…In terms of sample, the majority of UK studies were of the general population (15 studies) or community smoking cessation services (four studies), with three studies examining samples with specific characteristics (i.e., pregnant women, people aged 25–59 years, and English residents of Bangladeshi origin; see Table S3 in Supplement 2 of the Extended data 14 ). Mental health population studies were from Canada and sampled from people attending community mental health services (four studies) or from the general population (two studies).…”

“…The protocol was registered on PROSPERO CRD42021254551 on 13 th May 2021. Reporting follows PRISMA principles ( http://www.prisma-statement.org/ ) (see Extended data 14 ).…”

“… 7 , and Zhou et al . 21 All six studies were retrieved by the search (see the Extended data 14 ). Database search results were extracted directly to reference management software.…”