Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta-analysis

Nicola Black*, Maarten C. Eisma, Wolfgang Viechtbauer, Marie Johnston, Robert West, Jamie Hartmann-Boyce, Susan Michie, Marijn de Bruin

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Web of Science)

Abstract

Aims To examine variability and effectiveness of interventions provided to comparator (control) groups in smoking cessation trials.

Methods Systematic review with meta-analysis of randomized controlled trials (RCTs) of behavioral interventions for smoking cessation, with or without stop-smoking medication. We searched the Cochrane Tobacco Addiction Group Specialized Register for RCTs with objective outcomes measured at >= 6 months. Study authors were contacted to obtain comprehensive descriptions of their comparator interventions. Meta-regression analyses examined the relationships of smoking cessation rates with stop-smoking medication and behavior change techniques.

Results One hundred and four of 142 eligible comparator groups (n = 23 706) had complete data and were included in analyses. There was considerable variability in the number of behavior change techniques delivered [mean = 15.97, standard deviation (SD) = 13.54, range = 0-45] and the provision of smoking cessation medication (43% of groups received medication) throughout and within categories of comparator groups (e.g. usual care, brief advice). Higher smoking cessation rates were predicted by provision of medication [B = 0.334, 95% confidence interval (CI) = 0.030-0.638, P = 0.031] and number of behavior change techniques included (B = 0.020, 95% CI = 0.008-0.032, P <0.001). Modelled cessation rates in comparator groups that received the most intensive support were 15 percentage points higher than those that received the least (23 versus 8%).

Conclusions Interventions delivered to comparator groups in smoking cessation randomized controlled trials vary considerably in content, and cessation rates are strongly predicted by stop-smoking medication and number of behavior change techniques delivered.

Original languageEnglish
Pages (from-to)1607-1617
Number of pages11
JournalAddiction
Volume115
Issue number9
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Behavior change techniques
  • comparator group
  • control group
  • meta-analysis
  • meta-regression
  • smoking cessation
  • systematic review
  • BEHAVIOR-CHANGE TECHNIQUES
  • RANDOMIZED CONTROLLED-TRIALS
  • META-REGRESSION
  • ADHERENCE INTERVENTIONS
  • PHYSICAL-ACTIVITY
  • CARE
  • STANDARD
  • OUTCOMES
  • MANAGEMENT
  • CONSENSUS

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