Relapse prevention interventions for smoking cessation

Hájek, Peter; Stead, Lindsay F; West, Robert; Jarvis, Martin J.; Hartmann‐Boyce, Jamie; Lancaster, Tim

doi:10.1002/14651858.cd003999.pub4

Cited by 217 publications

(102 citation statements)

References 125 publications

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“…28 Among those women who do quit during pregnancy, nearly all wish to remain abstinent after the birth of their baby; 43 however, the vast majority relapse within 12 months of the birth. 44,45 Much less is known about effective interventions to prevent postnatal relapse; 45 behavioural support has not been shown to be effective for preventing postnatal relapse and is offered by only a minority of UK SSSs. 45 Smoking in pregnancy and postnatal relapse rates therefore remain high, particularly for women living in disadvantaged circumstances, 46 suggesting that this group of smokers face particular social and economic barriers that may inhibit their ability to access support and/or to stop smoking.…”

Section: Smoking Cessation In Pregnancymentioning

confidence: 99%

“…44,45 Much less is known about effective interventions to prevent postnatal relapse; 45 behavioural support has not been shown to be effective for preventing postnatal relapse and is offered by only a minority of UK SSSs. 45 Smoking in pregnancy and postnatal relapse rates therefore remain high, particularly for women living in disadvantaged circumstances, 46 suggesting that this group of smokers face particular social and economic barriers that may inhibit their ability to access support and/or to stop smoking. Understanding these barriers (and facilitators) offers scope for identifying other ways of reducing smoking in pregnancy and supporting women to remain abstinent after childbirth.…”

Section: Smoking Cessation In Pregnancymentioning

confidence: 99%

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Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study

Bauld

Graham

Sinclair

et al. 2017

Health Technol Assess

111

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Background: Although many women stop smoking in pregnancy, others continue, causing harm to maternal and child health. Smoking behaviour is influenced by many factors, including the role of women's significant others (SOs) and support from health-care professionals (HPs). Objectives: To enhance understanding of the barriers to, and facilitators of, smoking cessation and the feasibility and acceptability of interventions to reach and support pregnant women to stop smoking. Design: Four parts: (1) a description of interventions in the UK for smoking cessation in pregnancy; (2) three systematic reviews (syntheses) of qualitative research of women's, SOs' and HPs' views of smoking in pregnancy using meta-ethnography (interpretative approach for combining findings); (3) semistructured interviews with pregnant women, SOs and HPs, guided by the social-ecological framework (conceptualises behaviour as an outcome of individuals' interactions with environment); and (4) identification of new/ improved interventions for future testing. Setting: Studies in reviews conducted in high-income countries. Qualitative research was conducted from October 2013 to December 2014 in two mixed urban/rural study sites: area A (Scotland) and area B (England). Participants: Thirty-eight studies (1100 pregnant women) in 42 papers, nine studies (150 partners) in 14 papers and eight studies described in nine papers (190 HPs) included in reviews. Forty-one interviews with pregnant women, 32 interviews with pregnant women's SOs and 28 individual/group interviews with 48 HPs were conducted. Main outcome measures: The perceived barriers to, and facilitators of, smoking cessation in pregnancy and the identification of potential new/modified interventions. Results: Syntheses identified smoking-related perceptions and experiences for pregnant women and SOs that were fluid and context dependent with the capacity to help or hinder smoking cessation. Themes were analysed in accordance with the social-ecological framework levels. From the analysis of the interviews, the themes that were central to cessation in pregnancy at an individual level, and that reflected the findings from the reviews, were perception of risk to baby, self-efficacy, influence of close relationships and smoking as a way of coping with stress. Overall, pregnant smokers were faced with more barriers than facilitators. At an interpersonal level, partners' emotional and practical support, willingness to change smoking behaviour and role of smoking within relationships were important. Across the review and interviews of HPs, education to enhance knowledge and confidence in delivering information about smoking in pregnancy and the centrality of the client relationship, protection of which could be a factor in downplaying risks, were important. HPs acknowledged that they could best assist by providing support and understanding, and access to effective interventions, including an opt-out referral pathway to Stop Smoking Services, routine carbon monoxide screening, behavioural s...

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Section: Smoking Cessation In Pregnancymentioning

confidence: 99%

Section: Smoking Cessation In Pregnancymentioning

confidence: 99%

Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study

Bauld

Graham

Sinclair

et al. 2017

Health Technol Assess

111

View full text Add to dashboard Cite

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“…However, behavioural approaches to relapse prevention studies with virtual methods, such as mobile phone and applications, are still in infancy 52 . Review of relapse prevention intervention suggested no long-term benefit of behavioural intervention but recommends extended pharmacological treatment intervention 53 . The dose-response relationship is demonstrated in randomized control trial of web-based computer tailored intervention 53,54 .…”

Section: Review Papermentioning

confidence: 99%

“…Review of relapse prevention intervention suggested no long-term benefit of behavioural intervention but recommends extended pharmacological treatment intervention 53 . The dose-response relationship is demonstrated in randomized control trial of web-based computer tailored intervention 53,54 . We assume low relapse rate in our study due to the influence of frequent feedback and interaction sharing features.…”

Section: Review Papermentioning

confidence: 99%

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

Regmi¹,

Kassim²,

Ahmad³

et al. 2017

Tob. Prev. Cessation

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INTRODUCTION Smartphone-based smoking cessation interventions are increasingly used around the world. However, the effects of smartphone applications on applicability and efficacy on cessation rate and prevention of relapses are not often evaluated. Therefore, this review aims to assess the evidence on effectiveness of smartphone applications as an intervention tool for smoking cessation support. METHODS We conducted the search using Ovid Medline/PubMed, CENTRAL and Scopus databases dated (January 2007-June 2016. Inclusion criteria include randomized control trials or intervention studies with mobile applications that offer smoking cessation support. Two assessors independently extracted and evaluated the data from each included study. RESULTS The review of eight selected studies illustrate the use of smartphone applications in increasing quit rates among smokers, however adherence to app features influences quit rates. Audiovisual features followed by a quit plan, tracking progress and sharing features are most accepted and utilised app features. However, inconsistency was observed in their association with abstinence or quit rate. App engagement features increase the statistical significance in the quit rate. Development of smartphone applications was supported by behavior change theories in all studies nevertheless; heterogeneous forms of intervention were adopted within studies. Similarly, reduction in relapse attributed to enhanced discussion among quitters using social media applications was observed. CONCLUSIONS Quality evidence is warranted with large sample size to measure effect size of the intervention. Future research on effectiveness and efficacy of smartphone alone and comparisons with other mHealth interventions, such as text messaging would be useful.

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“…18 A Cochrane systematic review of trials of smoking relapse prevention found insufficient evidence to support the use of any specific intervention for preventing smoking relapse in short-term quitters. 19 The current smoking cessation guidelines do not recommend any specific interventions for smoking relapse prevention. 20,21 According to findings from a survey of smoking cessation professionals, the uncertain evidence base about effectiveness was an important barrier to the use of relapse prevention interventions in stop smoking practice.…”

Section: Interventions For Smoking Relapse Preventionmentioning

confidence: 99%

Effectiveness and economic evaluation of self-help educational materials for the prevention of smoking relapse: randomised controlled trial

Blyth

Maskrey

Notley

et al. 2015

Health Technol Assess

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BackgroundMost people who quit smoking successfully for a short period will return to smoking again in 12 months. A previous exploratory meta-analysis indicated that self-help booklets may be effective for smoking relapse prevention in unaided quitters.ObjectivesThis study aimed to evaluate the effectiveness of a set of self-help educational booklets to prevent smoking relapse in people who had stopped smoking with the aid of behavioural support.DesignThis is an open, randomised controlled trial and qualitative process evaluation. Trial participants were randomly allocated to one of two groups, using a simple randomisation process without attempts to stratify by participant characteristics. The participant allocation was ‘concealed’ because the recruitment of quitters occurred before the random allocation.SettingShort-term quitters were recruited from NHS Stop Smoking Clinics, and self-help educational materials were posted to study participants at home.ParticipantsA total of 1407 carbon monoxide (CO)-validated quitters at 4 weeks after quit date in NHS Stop Smoking Clinics. The trial excluded pregnant women and quitters who were not able to read the educational materials in English.InterventionsParticipants in the experimental group (n = 703) received a set of eight revisedForever Freebooklets, and participants in the control group (n = 704) received a single leaflet that is currently given to NHS patients.Main outcome measuresFollow-up telephone interviews were conducted 3 and 12 months after quit date. The primary outcome was prolonged, CO-verified abstinence from months 4 to 12 during which time no more than five cigarettes were smoked. The secondary outcomes included self-reported abstinence during the previous 7 days at 3 and 12 months, CO-verified abstinence at 12 months, costs (NHS and NHS and participant medication costs perspectives) and quality-adjusted life-years. Logistic regression analyses were conducted to investigate effect-modifying variables. A simultaneous qualitative process evaluation was conducted to help interpret the trial results.ResultsData from 1404 participants were used for the final analysis, after excluding three participants who died before the 12-month follow-up. The proportion with prolonged abstinence from months 4 to 12 after quit date was 36.9% in the intervention group and 38.6% in the control group. There was no statistically significant difference between the groups (odds ratio 0.93, 95% confidence interval 0.75 to 1.15;p = 0.509). There were no statistically significant differences between the groups in secondary smoking outcomes. People who reported knowing risky situations for relapse and using strategies to handle urges to smoke were less likely to relapse. However, there were no differences between the groups in the proportion of participants who reported that they knew any more about coping skills, and no differences in reported use of strategies to cope with urges to smoke between the trial groups. The qualitative study found that some quitters considered self-help booklets unhelpful for smoking relapse prevention, although positive feedback by participants was common.ConclusionsAmong quitters who had stopped smoking with the aid of intensive behavioural support, there was no significant difference in the likelihood of smoking relapse between those who subsequently received a set of eight revisedForever Freebooklets and those who received a single leaflet. Although many people had suboptimal strategies to prevent relapse and most relapsed, theForever Freebooklets proved an ineffective medium for teaching them the skills to prevent relapse. Further research should focus on interventions that may increase the use of coping skills when required.Trial registrationCurrent Controlled Trials ISRCTN36980856.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 59. See the NIHR Journals Library website for further project information.

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Relapse prevention interventions for smoking cessation

Cited by 217 publications

References 125 publications

Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study

Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

Effectiveness and economic evaluation of self-help educational materials for the prevention of smoking relapse: randomised controlled trial

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