Interventions to increase smoking cessation at the population level: how much progress has been made in the last two decades?

Abstract

This paper reviews the literature on smoking cessation interventions, with a focus on the last twenty years (1991 to 2010). These two decades witnessed major development in a wide range of cessation interventions, from pharmacotherapy to tobacco price increases. It was expected that these interventions would work conjointly to increase the cessation rate on the population level. This paper examines population data from the U.S., from 1991 to 2010, using the National Health Interview Surveys. Results indicate there is no consistent trend of increase in the population cessation rate over the last two decades. Various explanations are presented for this lack of improvement, and the key concept of Impact = Effectiveness × Reach is critically examined. Finally, it suggests that the field of cessation has focused so much on developing and promoting interventions to improve smokers’ odds of success that it has largely neglected to investigate how to get more smokers to try to quit and to try more frequently. Future research should examine whether increasing the rate of quit attempts would be key to improving the population cessation rate.

Evaluating the Effect of Access to Free Medication to Quit Smoking: A Clinical Trial Testing the Role of Motivation

“…In order to produce meaningful changes in cessation rates at the population level, a smoking intervention must not only be efficacious but must demonstrate potential for reaching a significant portion of the smoking population (Zhu, Lee, Zhuang, Gamst, & Wolfson, 2012). The current trial provides further evidence that the provision of NRT samples can be effectively delivered to smokers across the motivational spectrum.…”

Identification of Behavioral Risk Factors During Pregnancy

“…Healthy behavior through diet and respecting a daily serving meals program should be implemented at the general population level and addressed primarily to women, whether it is the pregnancy period, preparation for pregnancy or not [25].…”

Effects of different types of smoking cessation behavioural therapy in disadvantaged areas in the Netherlands: an observational study.

“…By comparison with the estimated background smoking cessation prevalence in the general population (1-4%) 44,45 , all the intervention types mentioned here had higher continuous abstinence prevalences than the background prevalence of abstinence. However, the magnitude differed greatly, with rolling and individual face-to-face counselling showing much greater abstinence prevalences above the background prevalence than telephone and fixed group counselling.…”