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Network Meta-Analysis of Behavioral Programs for Smoking Quit in Healthy People

  • Meng Xu
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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  • Kangle Guo
    Affiliations
    Gansu Provincial Hospital, Lanzhou, China
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  • Xue Shang
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Liying Zhou
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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  • Fenfen E
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Chaoqun Yang
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Yanan Wu
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Xiuxia Li
    Correspondence
    Address correspondence to: Xiuxia Li, MD, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Number 199 Donggang West Road, Lanzhou, 730000, China.
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Kehu Yang
    Affiliations
    Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author

      Introduction

      Smoking is a risk factor for most chronic diseases and premature death, with a global prevalence of more than 1 billion people who smoke. This network meta-analysis aimed to investigate the impact of different behavioral interventions on smoking cessation.

      Methods

      Four electronic databases were searched for RCTs from inception to August 29, 2022. The risk of bias for the included RCTs was evaluated using the revised version of Cochrane tool for assessing risk of bias and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. The network meta-analysis was performed using Stata 16SE and R 4.1.3 software.

      Results

      A total of 119 included RCTs enrolled 118,935 participants. For the 7-day-point prevalence abstinence rate, video counseling had a best intervention effect than brief advice, followed by financial incentives, self-help materials plus telephone counseling, motivational interview, health education, telephone counseling, and text messages. For the 30-day-point prevalence abstinence rate, face-to-face cognitive education and financial incentives were superior to brief advice. For the continuous abstinence rate, motivational interview and financial incentives were more effective than brief advice. The certainty of evidence was very low to moderate for these studies.

      Discussion

      From the results of the network meta-analysis, different behavioral interventions resulted in positive impacts on smoking cessation compared with that of brief advice, especially video counseling, face-to-face cognitive education, and motivational interviews. Owing to the poor quality of evidence, high-quality trials should be conducted in the future to provide more robust evidence.
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