We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Interventions for Tobacco Cessation in Adults, Including Pregnant Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.
- Authors
Patnode, Carrie D.; Henderson, Jillian T.; Coppola, Erin L.; Melnikow, Joy; Durbin, Shauna; Thomas, Rachel G.
- Abstract
SELECTION Systematic reviews of tobacco cessation interventions and randomized clinical trials that evaluated the effects of electronic cigarettes (e-cigarettes) or pharmacotherapy among pregnant persons. DATA EXTRACTION AND SYNTHESIS Independent critical appraisal and data abstraction; qualitative synthesis and random-effects meta-analyses. MAIN OUTCOMES AND MEASURES Health outcomes, tobacco cessation at 6 months or more, and adverse events. RESULTS Sixty-seven reviews addressing pharmacotherapy and behavioral interventions were included as well as 9 trials (N = 3942) addressing e-cigarettes for smoking cessation and 7 trials (N = 2285) of nicotine replacement therapy (NRT) use in pregnancy. Combined pharmacotherapy and behavioral interventions (pooled risk ratio [RR], 1.83 [95%CI, 1.68-1.98]), NRT (RR, 1.55 [95%CI, 1.49-1.61]), bupropion (RR, 1.64 [95%CI, 1.52-1.77]), varenicline (RR, 2.24 [95%CI, 2.06-2.43]), and behavioral interventions such as advice from clinicians (RR, 1.76 [95%CI, 1.58-1.96]) were all associated with increased quit rates compared with minimal support or placebo at 6 months or longer. None of the drugs were associated with serious adverse events. Five trials (n = 3117) reported inconsistent findings on the effectiveness of electronic cigarettes on smoking cessation at 6 to 12 months among smokers when compared with placebo or NRT, and none suggested higher rates of serious adverse events. Among pregnant persons, behavioral interventions were associated with greater smoking cessation during late pregnancy (RR, 1.35 [95%CI, 1.23-1.48]), compared with no intervention. Rates of validated cessation among pregnant women allocated to NRT compared with placebo were not significantly different (pooled RR, 1.11 [95%CI, 0.79-1.56], n = 2033). CONCLUSIONS AND RELEVANCE There is strong evidence that a range of pharmacologic and behavioral interventions, both individually and in combination, are effective in increasing smoking cessation in nonpregnant adults. In pregnancy, behavioral interventions are effective for smoking cessation, but data are limited on the use of pharmacotherapy for smoking cessation. Data on the effectiveness and safety of electronic cigarettes for smoking cessation among adults are also limited and results are inconsistent.
- Publication
JAMA: Journal of the American Medical Association, 2021, Vol 325, Issue 3, p280
- ISSN
0098-7484
- Publication type
Article
- DOI
10.1001/jama.2020.23541