Individual behavioural counselling for smoking cessation

 

Abstract

Background

Individual counselling from a smoking cessation specialist may help smokers to make a successful attempt to stop smoking.

Objectives

The objective of the review is to determine the effects of individual counselling.

Search methods

We searched the Cochrane Tobacco Addiction Group Specialized Register for studies with counsel* in any field. Date of the most recent search: May 2008.

Selection criteria

Randomized or quasi-randomized trials with at least one treatment arm consisting of face-to-face individual counselling from a healthcare worker not involved in routine clinical care. The outcome was smoking cessation at follow up at least six months after the start of counselling.

Data collection and analysis

Both authors extracted data. The intervention and population, method of randomization and completeness of follow up were recorded.

Main results

We identified 30 trials with over 7000 participants. Twenty-two trials compared individual counselling to a minimal behavioural intervention. Individual counselling was more effective than control. The relative risk (RR) for smoking cessation at long-term follow up was 1.39, 95% confidence interval (CI) 1.24 to 1.57. In a subgroup of four trials where all participants received nicotine replacement therapy the point estimate of effect for counselling was smaller but just reached significance (RR 1.27; 95% CI 1.02 to 1.59). We failed to detect a greater effect of intensive counselling compared to brief counselling (5 trials, RR 0.96, 95% CI 0.74 to 1.25). None of the three other trials that compared different counselling models of similar intensity detected significant differences.

Authors' conclusions

Individually delivered smoking cessation counselling can assist smokers to quit.

 

Plain language summary

Does individually delivered counselling help people to stop smoking

Individual counselling is commonly used to help people who are trying to quit smoking. The review looked at trials of counselling by a trained therapist providing one or more face-to-face sessions, separate from medical care. All the trials involved sessions of more than 10 minutes, with most also including further telephone contact for support. The review found that individual counselling could help smokers quit, but there was not enough evidence about whether more intensive counselling was better.

 

摘要

背景

個別行為諮商戒菸

由戒菸專家所進行的個別諮商可能有助於吸菸者嘗試戒菸。

目標

本篇回顧的目的是確定個別諮商的效果。

搜尋策略

我們搜尋The Cochrane Tobacco Addiction Group Specilized Register 的研究，有關counsel的任何領域，搜尋至2004年12月。

選擇標準

隨機或半隨機研究中，至少有一個處遇是健康照護者面對面的個別諮商，而非一般性的臨床醫療處置。結果變項是在開始諮商後至少追蹤6個月的戒菸狀況。

資料收集與分析

由兩位作者摘錄資料，紀錄治療處置、樣本、取樣的方法、治療後是否完成追蹤。

主要結論

我們確認出有超過7000名參與者的21個研究。18篇的研究是比較個別諮商和些微行為處置，其中的4篇是比較不同型態或不同深度的諮商。比起對照組，個別諮商顯得較有效。成功戒菸的勝算比(odds ratio)是1.56 (95% 信賴區間 1.32 to 1.84)。在3個研究中，所有受試者都接受尼古丁替代療法的組別中，發現點估計的效果都相當小，而且無法達到統計的顯著差異(勝算比 1.34, 95% 信賴區間 0.98 to 1.83). 比起簡短諮商，我們沒有辦法發現更深入的諮商有較強的效果(勝算比 0.98, 95% 信賴區間 0.61 to 1.56).

作者結論

戒菸諮商有助於吸菸者戒菸。

翻譯人

本摘要由彰化基督教醫院胡淑惠翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

個別諮商有助於吸菸者戒菸。個別諮商通常能協助想戒菸的人。這篇文獻的目的是和醫療照護區分開，觀察由受過訓練的治療者所提供的一個或多個面對面的諮商的研究。所有研究的治療時間都超過10分鐘，而且大部分在之後都透過電話繼續提供支持。此篇文獻發現個別諮商有助於吸菸者戒菸，但並沒有足夠的證據顯示更深入的諮商效果更好。