Limited evidence for the effectiveness of stage-based intervention strategies in influencing smoking behaviour

West, Robert PhD

Cancer Research UK Health Behaviour Unit; University College London; London, UK

Abstracted from:Riemsma R, Pattenden J, Bridle C et al. Systematic review of the effectiveness of stage based interventions to promote smoking cessation. BMJ 2003; 326: 1175-1177 .

Sources of funding: NHS research and development health technology assessment programme.

Correspondence to: R. Riemsma, Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK. E-mail: [email protected].

Abstract provided by Bazian Ltd, London

Evidence-based Healthcare 7(4):p 174-176, December 2003.

BACKGROUND

Stopping smoking significantly reduces the risk of acquiring a smoking-related disease. Stage-based intervention strategies identify different behavioural stages through which a person sequentially progresses until the desired behavioural outcome is attained. The effectiveness of such a strategy in influencing smoking behaviour is yet to be established.

OBJECTIVE

To assess the effectiveness of stage-based interventions in influencing smoking behaviour.

METHOD

Systematic review with qualitative synthesis.

SEARCH STRATEGY

Thirty-five electronic databases, catalogues and Internet resources were searched from inception to July 2002. Bibliographies were hand searched, and authors of conference abstracts contacted for further information.

INCLUSION/EXCLUSION CRITERIA

Eligible studies were randomised controlled trials assessing the effectiveness of stage-based interventions in influencing smoking behaviour (defined as an actual change in behaviour or transition through different stages) in people who smoked. There were no language restrictions.

OUTCOMES

Primary outcomes were smoking behaviour and movement through behavioural stages.

MAIN RESULTS

Twenty-three randomised controlled trials were identified. The majority of studies (20/23) failed to specify the instrument or methodology used to assess each behavioural stage, making it difficult to accurately assess the extent to which interventions were stage-based. Stage-based interventions significantly increased smoking cessation rates compared to either usual care (seven trials) or a non-stage-based intervention (one trial). Twelve trials showed no significant difference between treatment groups; the remaining three trials were inconclusive.

AUTHORS' CONCLUSIONS

There is limited evidence for the effectiveness of stage-based intervention strategies in influencing smoking behaviour.