The effectiveness of smoking cessation interventions for socio-economically disadvantaged women: a systematic review and meta-analysis

Abstract

Introduction This systematic review and meta-analysis assessed the effectiveness of smoking cessation interventions among women smokers in low socio-economic status (SES) groups or women living in disadvantaged areas who are historically underserved by smoking cessation services. Methods A systematic literature search was conducted using MEDLINE (OVID), EMBASE, Cochrane, CINAHL, PsychINFO and Web of Science databases. Eligibility criteria included randomised controlled trials of any smoking cessation intervention among women in low SES groups or living in socio-economically disadvantaged areas. A random effects meta-analysis assessed effectiveness of interventions on smoking cessation. Risk of bias was assessed with the Cochrane Risk of Bias tool. The GRADE approach established certainty of evidence. Results A total of 396 studies were screened for eligibility and 11 (6153 female participants) were included. Seven studies targeted women-only. 5/11 tested a form of face-to-face support. A pooled effect size was estimated in 10/11 studies. At end of treatment, two-thirds more low SES women who received a smoking cessation intervention were more likely to stop smoking than women in control groups (risk ratio (RR) 1.68, 95% CI 1.36–2.08, I2= 34%). The effect was reduced but remained significant when longest available follow-up periods were pooled (RR 1.23, 95% CI 1.04–1.48, I2 = 0%). There was moderate-to-high risk of bias in most studies. Certainty of evidence was low. Conclusions Behavioural and behavioural + pharmacotherapy interventions for smoking cessation targeting women in low SES groups or women living in areas of disadvantage were effective in the short term. However, longer follow-up periods indicated reduced effectiveness. Future studies to explore ways to prevent smoking relapse in this population are needed. Systematic review registration PROSPERO: CRD42019130160

Conducting co-creation for public health in low and middle-income countries: a systematic review and key informant perspectives on implementation barriers and facilitators

“…Targeted people living in LMICs according to the Organisation for Economic Co-operation and Development’s (OECD) list of 2022–2023 [ 26 ] and in socio-economically vulnerable circumstances. The latter was described as a ‘neighbourhood socioeconomic disadvantage’ (including but not limited to disadvantaged communities, poverty, neighbourhood/area status); or any definition of ‘individually measured disadvantage’ (including but not limited to low income, entitlement to medical or other state benefits, unemployment, low educational status and social class) [ 27 ].…”

A Review of Smoking Cessation Interventions: Efficacy, Strategies for Implementation, and Future Directions

“…Research conducted by O'Connell et al has revealed that individuals with lower socioeconomic status (SES) exhibit poorer responsiveness to available interventions and a higher prevalence of smoking-related comorbidities compared to their higher SES counterparts. Furthermore, gender differences are noteworthy, with women, particularly those of lower SES, facing greater challenges in quitting due to factors such as smoking dependency, limited access to interventions, stress-coping mechanisms, time constraints, and concerns about the financial implications of smoking cessation [18].…”