Smoking cessation interventions on health-care workers: a systematic review and meta-analysis

Abstract

Objective The authors carried out a systematic review and a meta-analysis on smoking cessation interventions on health -care workers to clarify the state of the art interventions and to identify the best one. Materials and Methods This review was registered with PROSPERO: CRD42019130117. The databases PubMed, Scopus, Web of Science and CINAHL were searched until December 2018. Quality of all studies included in the systematic review was assessed according to the Newcastle-Ottawa Scale (NOS) on cohort or cross-sectional studies and to the Cochrane Risk of Bias Tool for Randomized Controlled Trials. Meta-analysis and meta-regression analyses were also carried out for cohort studies (quasi-experimental or a before-after studies design) and clinical trials. Results Twenty–four studies have been included in the analysis: four before-after, 13 cross-sectional, three quasi-experimental studies and four clinical trials. Articles were heterogeneous (P for homogeneity <0.01), but they have all shown positive results since they reached the goal of smoking cessation among health-care workers, even if with different proportions. Meta-analysis was performed on 10 studies (six cohort studies and four clinical trials), showing a 21% of success rate from the application of smoking cessation interventions, either pharmacological or behavioral ones. The resulted pooled RR (Risk Ratio) was 1.21 (95% CI [1.06–1.38]), being 24% of success rate from clinical trials (pooled RR 1.244; 95% CI [1.099–1.407]) and 19% of success rate from cohort studies (pooled RR 1.192; 0.996–1.426). However, two studies have confidence intervals which include unity and one study has a wide confidence interval; as a consequence, the meta-analysis for its results depends heavily on one single study. Meta-regression analysis revealed that results were influenced by the number of participants. Conclusion Both policy and pharmaceutical interventions can obtain positive results in quitting smoking among health-care workers. However, as shown by our review, combination approaches can produce better results in terms of cessation percentages and smoking abstinence.

Are Nigerian oral health workers overlooking opportunities to promote interventions for tobacco smoking cessation?

“…Only 120 (18.3%) of the patients in our review were routinely offered cessation assistance. Currently, most tobacco cessation interventions are provided by physicians, even though all healthcare providers can be equally effective 36 . Edwards et al 37 surveyed Australian dentists and dental hygienists and found that these practitioners indicated high rates of advising patients to quit smoking, but low rates of assisting and referring patients to smoking-cessation experts.…”

“…A study done by Wyne et al 36 revealed confusion in the dental community regarding the extent of the dentist's responsibility and role in tobacco intervention. Only a minority thought of tobacco intervention as their responsibility to a 'great extent'.…”

Prevalence and correlates of anxiety and depression in frontline healthcare workers treating people with COVID-19 in Bangladesh

“…Therefore, if the associations between low exercise and/or smoking, and poor mental health are causal [68][69][70], risk reduction strategies focusing on regular exercise and smoking discontinuation may be helpful in reducing potentially deleterious impacts of COVID-19 on the mental health of HCWs. In such efforts, combination approaches may be particularly relevant [71]; however, other stress-reduction approaches (e.g., meditation, massage) may be helpful, although more research is needed in this area [72]. Further, some benefits of engaging in physical activity may be transmitted to patients, although this too warrants further study [73].…”

Behaviors and Attitudes Toward Smoking Among Health Care Workers at Health Facilities in 4 Provinces of Vietnam: A Representative Cross-Sectional Survey

“…Promisingly, our study found that 72% of our smoking HCWs had attempted to quit in the past 12 months. With >90% of our participants agreeing that free smoking cessation programs should be available, this study provides evidence for the openness of HCWs to support evidence-based tobacco control measures, 21 if staff are adequately supported. We also showed that a minority of HCWs who are smokers have a high level of nicotine dependence, and most are motivated to quit.…”

“…Interventions to increase the availability of smoking cessation services for HCWs will contribute to reducing smoking among patients. 21 Capacity-building interventions to augment the counselling skills of HCWs and provide access to evidence-based methods of smoking cessation (such as pharmacotherapy and brief counselling) 11,23,24 promise to reduce smoking rates among patients presenting to health facilities. A system-wide approach is critical if smoking rates are to reduce among patients and HCWs.…”