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Effect of increasing behavioural support. Abstinence at longest follow‐up.Subgroups by type of pharmacotherapy
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Figure 1

Effect of increasing behavioural support. Abstinence at longest follow‐up.

Subgroups by type of pharmacotherapy

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Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 1 Subgroups by type of pharmacotherapy.
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Analysis 1.1

Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 1 Subgroups by type of pharmacotherapy.

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Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 2 Subgroups by contrast in number of contacts between intervention & control.
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Analysis 1.2

Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 2 Subgroups by contrast in number of contacts between intervention & control.

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Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 3 Subgroups by duration of contact in control condition (not prespecified).
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Analysis 1.3

Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 3 Subgroups by duration of contact in control condition (not prespecified).

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Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 4 Subgroup by modality of contact (not prespecified).
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Analysis 1.4

Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 4 Subgroup by modality of contact (not prespecified).

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Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 5 Subgroups by setting.
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Analysis 1.5

Comparison 1 Effect of increasing behavioural support. Abstinence at longest follow‐up, Outcome 5 Subgroups by setting.

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Comparison 2 Sensitivity analyses, Outcome 1 Sensitivity analysis including intermediate intensity conditions. Adjunct behavioural support versus pharmacotherapy alone.
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Analysis 2.1

Comparison 2 Sensitivity analyses, Outcome 1 Sensitivity analysis including intermediate intensity conditions. Adjunct behavioural support versus pharmacotherapy alone.

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Comparison 2 Sensitivity analyses, Outcome 2 By outcome definition.
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Analysis 2.2

Comparison 2 Sensitivity analyses, Outcome 2 By outcome definition.

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Summary of findings for the main comparison. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation

Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation

Patient or population: People using smoking cessation pharmacotherapy
Settings: Health care and community settings
Intervention: Behavioural interventions as adjuncts to pharmacotherapy

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Behavioural interventions as adjuncts to pharmacotherapy

Smoking cessation at longest follow‐up
Follow‐up: 6 ‐ 24 months

Study population

RR 1.16
(1.09 to 1.24)

15506
(38 studies)

⊕⊕⊕⊕
high1,2

183 per 1000

213 per 1000
(200 to 227)

Median quit rate

210 per 1000

244 per 1000
(229 to 260)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 All studies rated at low or unclear risk of bias
2 No overall evidence of statistical heterogeneity (I² = 3%), or of differences between the subgroups defined by pharmacotherapy

Figures and Tables -
Summary of findings for the main comparison. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation
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Comparison 1. Effect of increasing behavioural support. Abstinence at longest follow‐up

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Subgroups by type of pharmacotherapy Show forest plot

38

15506

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.09, 1.24]

1.1 NRT

27

9772

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [1.06, 1.25]

1.2 Bupropion

4

1995

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [1.08, 1.44]

1.3 Nortriptyline

2

172

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.59, 1.63]

1.4 Varenicline

1

800

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [0.89, 1.37]

1.5 NRT & bupropion

2

690

Risk Ratio (M‐H, Fixed, 95% CI)

1.22 [0.98, 1.52]

1.6 Choice of pharmacotherapy

3

2077

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.92, 1.45]

2 Subgroups by contrast in number of contacts between intervention & control Show forest plot

38

15506

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.09, 1.24]

2.1 4 to 8 or > 8 contacts versus no contact

6

3762

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [1.08, 1.45]

2.2 More than 8 contacts versus 1 to 3 contacts

2

609

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.66, 1.18]

2.3 4 to 8 contacts versus 1 to 3 contacts

12

6817

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.07, 1.27]

2.4 More than 8 contacts versus 4‐8 contacts

9

1568

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.98, 1.35]

2.5 Intervention & control in same contact category

9

2750

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.97, 1.41]

3 Subgroups by duration of contact in control condition (not prespecified) Show forest plot

38

15506

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.09, 1.24]

3.1 'Brief intervention' for control

20

11042

Risk Ratio (M‐H, Fixed, 95% CI)

1.18 [1.10, 1.27]

3.2 'Dose response', over 30 minutes contact for control

18

4464

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [0.99, 1.25]

4 Subgroup by modality of contact (not prespecified) Show forest plot

38

15506

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.09, 1.24]

4.1 All contact by telephone

6

5311

Risk Ratio (M‐H, Fixed, 95% CI)

1.28 [1.17, 1.41]

4.2 No contact for control group, face‐to‐face intervention

3

2364

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.88, 1.35]

4.3 Face‐to‐face contact for both intervention & control conditions

29

7831

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.99, 1.19]

5 Subgroups by setting Show forest plot

38

15506

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.09, 1.24]

5.1 Recruited and treatment initiated in health care setting

12

5422

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.94, 1.26]

5.2 Members of health care organisation

3

2833

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [1.07, 1.37]

5.3 Community volunteers

23

7251

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [1.08, 1.27]
Figures and Tables -
Comparison 1. Effect of increasing behavioural support. Abstinence at longest follow‐up
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Comparison 2. Sensitivity analyses

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Sensitivity analysis including intermediate intensity conditions. Adjunct behavioural support versus pharmacotherapy alone Show forest plot

38

17804

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [1.08, 1.22]

1.1 NRT

27

11430

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [1.04, 1.22]

1.2 Bupropion

4

1995

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [1.08, 1.44]

1.3 Nortriptyline

2

172

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.59, 1.63]

1.4 Varenicline

1

1202

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [0.92, 1.34]

1.5 NRT & bupropion

2

690

Risk Ratio (M‐H, Fixed, 95% CI)

1.22 [0.98, 1.52]

1.6 Choice of pharmacotherapy

3

2315

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.92, 1.43]

2 By outcome definition Show forest plot

38

15506

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [1.09, 1.24]

2.1 12m validation PP outcomes only

14

3202

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.88, 1.15]

2.2 12m validated sustained outcomes

7

2322

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.87, 1.36]

2.3 Not 12m

9

2783

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [1.04, 1.40]

2.4 No validation at all

8

7199

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [1.14, 1.35]
Figures and Tables -
Comparison 2. Sensitivity analyses
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