Am Fam Physician. 2022;105(2):133-135
Author disclosure: No relevant financial relationships.
Clinical Question
Which behavioral interventions help people quit smoking, and what factors influence how successful they are?
Evidence-Based Answer
A variety of behavioral interventions are effective for smoking cessation. Providing individual or group counseling (odds ratio [OR] = 1.44; 95% credibility interval [CrI], 1.22 to 1.70; number needed to treat [NNT] = 40), guaranteed financial incentives (OR = 1.46; 95% CrI, 1.15 to 1.85; NNT = 29), and text message–based counseling (OR = 1.45; 95% CrI, 1.17 to 1.80; NNT = 33) provide the greatest benefit. Population characteristics do not consistently affect the success of these interventions. All of the interventions provide additional benefit even when smoking cessation pharmacotherapy is prescribed. There are no apparent harms of behavioral interventions.1 (Strength of Recommendation: A, based on consistent, good-quality patient-oriented evidence.)
| Intervention | Probable outcome with intervention | Probable outcome without intervention | NNT (95% CI) | Participants (studies) | Evidence quality |
|---|---|---|---|---|---|
| Guaranteed financial incentives | 106 per 1,000 (95% CI, 91 to 123) | 71 per 1,000 | 29 (19 to 50) | 20,097 (30 RCTs) | High |
| Text message–based counseling | 90 per 1,000 (95% CI, 70 to 110) | 60 per 1,000 | 33 (20 to 100) | 14,133 (13 RCTs) | Moderate |
| Individual counseling | 110 per 1,000 (95% CI, 100 to 120) | 70 per 1,000 | 25 (20 to 33) | 11,100 (27 RCTs) | High |
| Group counseling | 90 per 1,000 (95% CI, 80 to 120) | 50 per 1,000 | 25 (14 to 33) | 4,395 (13 RCTs) | Moderate |
| Printed self-help materials | 60 per 1,000 (95% CI, 52 to 69) | 50 per 1,000 | NA | 13,241 (11 RCTs) | Moderate |
| Internet-based interventions | 148 per 1,000 (95% CI, 130 to 167) | 129 per 1,000 | NA | 6,786 (8 RCTs) | Low |
| Telephone counseling | 100 per 1,000 (95% CI, 85 to 116) | 72 per 1,000 | 36 (23 to 77) | 32,484 (14 RCTs) | Moderate |
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