Combined Approach To Stop Smoking Is Most Effective

Smokers who try to quit are more successful when they combined medication or nicotine-replacement therapy with behavioral counseling. This is the finding from a new review in The Cochrane Library. Quitting smoking is one of the most important things a person can do to improve their health, including improved circulation, lowered blood pressure, and a decreased risk of cancer and heart disease.

“Since we know that both types of treatment are effective, the assumption has certainly been that offering both will be better than offering either alone,” said lead researcher Lindsay Stead of the department of primary health care sciences at the University of Oxford. She and her coauthor sought to confirm this observation by measuring the effects of combining behavioral and medication therapy versus no intervention or medication therapy alone. The reviewers pooled findings from 41 studies involving more than 20,000 smokers.

The review found that a combination of medication and behavioral therapy improved quit rates by as much as 70% to 100% compared to no treatment or minimal intervention. Behavioral therapy interventions typically included 4 to 8 sessions with smoking cessation counselors, psychologists, or physicians.

”Health care providers have an important role in convincing smokers of the importance of attempting to quit and making pharmacotherapy and behavioral support available,” the researchers stated.

“Usual care in most health care systems for smoking cessation typically consists of brief pre-quit counseling, a recommendation to use, and possible provision of cessation medication, and a follow-up visit or phone call a few weeks later,” said Stevens S. Smith, Ph.D., associate professor in the department of medicine at the University of Wisconsin’s Center for Tobacco Research and Intervention.

“For patients motivated to make a quit attempt, counseling and assistance with medications — if medically appropriate — should be provided,” said Smith. “For patients not motivated to quit, the doctor should use motivational interventions. Another option is referral to publicly available tobacco quit phone lines.

This information was adapted from Health Behavior News Service, part of the Center for Advancing Health.

Dr. Christopher Fisher provides behavioral medicine treatment for smoking cessation in individual and group therapy formats. Please feel free to contact us with additional questions.

Stead LF, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD008286. DOI: 10.1002/14651858.CD008286.pub2.