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Individual behavioural counselling for smoking cessation

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Abstract

Background

Individual counselling from a smoking cessation specialist may help smokers to make a successful attempt to stop smoking.

Objectives

The objective of the review is to determine the effects of individual counselling.

Search methods

We searched the Cochrane Tobacco Addiction Group Specialized Register for studies with counsel* in any field. Date of the most recent search: May 2008.

Selection criteria

Randomized or quasi‐randomized trials with at least one treatment arm consisting of face‐to‐face individual counselling from a healthcare worker not involved in routine clinical care. The outcome was smoking cessation at follow up at least six months after the start of counselling.

Data collection and analysis

Both authors extracted data. The intervention and population, method of randomization and completeness of follow up were recorded.

Main results

We identified 30 trials with over 7000 participants. Twenty‐two trials compared individual counselling to a minimal behavioural intervention. Individual counselling was more effective than control. The relative risk (RR) for smoking cessation at long‐term follow up was 1.39, 95% confidence interval (CI) 1.24 to 1.57. In a subgroup of four trials where all participants received nicotine replacement therapy the point estimate of effect for counselling was smaller but just reached significance (RR 1.27; 95% CI 1.02 to 1.59). We failed to detect a greater effect of intensive counselling compared to brief counselling (5 trials, RR 0.96, 95% CI 0.74 to 1.25). None of the three other trials that compared different counselling models of similar intensity detected significant differences.

Authors' conclusions

Individually delivered smoking cessation counselling can assist smokers to quit.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Does individually delivered counselling help people to stop smoking

Individual counselling is commonly used to help people who are trying to quit smoking. The review looked at trials of counselling by a trained therapist providing one or more face‐to‐face sessions, separate from medical care. All the trials involved sessions of more than 10 minutes, with most also including further telephone contact for support. The review found that individual counselling could help smokers quit, but there was not enough evidence about whether more intensive counselling was better.