3.1. Study selection
Following the removal of duplicates, a total of 2463 articles were considered at the title and abstract level. One-hundred-and-seven full texts were reviewed, and 77 were excluded with reasons (see Fig. 1 and Appendix 1), with 29 unique studies meeting the eligibility criteria. Full details of the search results are summarized in Fig. 1. PRISMA Flowchart.
Details of included studies and participant’s characteristics
Thirteen of the included studies were randomised controlled trials (RCTs) (n= 2828) and 16 studies were quasi controlled studies (n=1172). The sample size across the studies ranged from 9 36 to 775 participants.21 The mean age of participants ranged from 32.4 years18 to 56.9 38 with an overall mean age of 39.55 years (three studies did not report mean age). A minority of study participants identified as female (33.43%; with two studies not reporting gender).
Several studies focussed on people with severe mental illness 11, 13-14, 17, 21, 30-32, 38-39 and people who use alcohol and other drugs.12, 18, 20-21, 35, 37, 32 Other studies focussed on people experiencing homelessness25, 27, 28, 36 those involved with the criminal justice system 16, 22, 34 and those living with HIV.16, 23-24, 26 Three studies included indigenous groups 19,21,32 and LGBTQ+ populations.29 One study included individuals with affective disorders; individuals with opioid use disorder and smokers with socioeconomic disadvantage21 whilst another study included Aboriginal people; people with serious mental illness and people who use drugs32. No studies evaluating interventions engaging with members of the Traveller community, sex worker or migrants were identified. Details regarding the included studies are summarized in Tables 1 (controlled trials) and 2 (uncontrolled trials).
Table 1 Controlled Studies
Study authors, Year
|
Design, region, setting
|
Population
|
Intervention
|
Control group
|
Follow up
|
Allen et al. (2011)11
|
RCT, Switzerland, psychiatric emergency service
|
People with serious mental illness- schizophrenia (n=40);
Gender: % female (unknown);
Age: Mean (unknown) range (18-65 years).
|
21mg transdermal nicotine patch
|
placebo patch
|
24 hours
|
Carmody et al. (2012)12
|
RCT, hospital-based substance use program, United States
|
People dependent on alcohol (n=162);
3.18 % female;
Age: median age (50), age range (unknown) .
|
16 sessions of CBT+ NRT over 36 weeks
|
Usual care: Smoking cessation counselling and guideline-concordant medications
|
52 weeks
|
Chan et al., 202013
|
Cluster randomised parallel study, psychiatric inpatient, Taiwan
|
People with mental illness (n= 310)
Gender: 10.9% female;
Age: 36.92 ± 8.1.
|
Inhalers, nicotine gum, and nicotine patches
|
N/A
|
8 weeks
|
Christiansen et al (2018)14
|
RCT, outpatient care program, United States
|
People with serious mental health issues (n=222);
Gender (49% female);
Age (43.8 ±9.9.
|
Four weekly sessions; motivational component; pre-quit nicotine patch (21mg)
|
Attention control group
|
3 months
|
Cropsey (2008)15
|
RCT, state prison, United States
|
Women in a state prison (treatment: n=250; control: n= 289);
Gender (100% female);
Age (33.8 ±9).
|
10-week group intervention with NRT (patches according to manufacturer instructions)
|
No intervention
|
12 month follow up
|
Cropsey et al., (2014)16
|
Randomised pilot study, HIV clinic, United States
|
People living with HIV (n=40)
Gender: 42.5% female;
Age: 44.5±SD = 9.9.
|
8-weeks of combination nicotine replacement therapy (NRT) in conjunction with brief counselling (SBIRT framework)
|
Usual Care
|
8 weeks
|
Dennis et al., (2016)17
|
RCT, outpatient hospital, United States
|
People with serious mental illness- Post Traumatic Stress Disorder (n=63)
Gender: (55% female)
Age: 42.3 ±10.7
|
Nicotine patch pre-loading
|
Placebo patch
|
6 month
|
Felicione et al (2018)18
|
RCT, outpatient clinic, United States
|
People who use drugs (n=25)
Gender: 72% female;
Age: 32.4 ±8.7.
|
ENDS device
|
Placebo liquid
|
4 weeks
|
Gould et al. (2019)19
|
RCT, Aboriginal medical services, Australia
|
Pregnant Australian indigenous women (n=22)
Gender: 100% female
Age: 16+
|
Education resource package (including webinars; 3 hour one sessions); oral forms of NRT; CO monitoring
|
Stepwedge design
|
6 months
|
Hall et al. (2018)20
|
RCT, buprenorphine clinic, United States
|
People who use drugs (n=175)
Gender: 22% female
Age: Treatment (40.5±10.5); Control (40.6±SD 9.7)
|
Computerised motivational feedback; nicotine gum lozenge; nicotine patch; optional varenicline for those who failed to achieve 24 hour abstinence
|
Brochures on quitting; self-help techniques; helplines; smoking cessation controls
|
18 months
|
Higgins et al., (2020)21
|
3 RCTs, University Setting, United States
|
Individuals with affective disorders; individuals with opioid use disorder and women smokers with socioeconomic disadvantage (n=775)
Gender: 71.1, female;
Age: 35.59 (11.05)
|
12 week intervention with free cigarettes provided with three concentration of nicotine 0.4, 2.4, or 15.8 mg
|
N/A
|
16 weeks
|
Jalali et al., (2015)22
|
RCT, prison, Iran
|
People involved with criminal justice system (n=43)
Gender: 0% female
Age: 37.59 ± 8.76
|
MI-based treatment, MI with NRT, and the control group,
Motivation interview + 2mg gum for every cigarette smoked/ over 5 weeks
|
No intervention
MI
|
90 days
|
Stanton et al., (2009)23
|
RCT, outpatient clinic, United States
|
People living with HIV (n= 412)
Gender: 36.89% female
Age: 42.04±7.53
|
8 weeks
Bi weekly sessions where patch used was discussed
|
two study sessions, consisting largely of baseline assessments, randomization, and brief assessment of quitting plans. NRT for those who wanted to quit
|
6 months
|
Table 2 Uncontrolled studies
Study authors, Year
|
Design, region, setting
|
Population
|
Intervention
|
Follow up
|
Balfour et al., (2016)24
|
Pilot study, HIV outpatient clinic, United States
|
People living with HIV (n=50) ;
Gender: 12% female
Age: 45.10±8.68
|
5 session smoking cessation counselling, NRT Nicotine patch per following dosage regiment: participants smoking ≥20 cigarettes per day were prescribed 21 mg patches daily for 6 weeks, then 14 mg/day for 2 weeks, followed by 7 mg/day for 2 weeks; participants smoking 10–20 cigarettes per day were prescribed 14 mg patches daily for 6 weeks, and then 7 mg/day for 4 weeks
|
6 months
|
Buckley et al., (2017) 25
|
Evaluation study, homeless service, United States
|
People experiencing homelessness (n=139)
Gender: 27.3%, female;
Age: 44.2± 19-74;
|
Student run intervention; smoking cessation education; motivational interviewing; 2 weeks supply of NRT; referral to national quitline.
|
26 weeks
|
Cioe et al., (2019)26
|
Pilot study, outpatient HIV clinic
|
People living with HIV (n=19);
Gender: 30%, female;
Age: 52.7±9.3.
|
8 week intervention; participants provided with an ENDS device; weekly allotments of nicotine liquid;
|
12 weeks
|
Collins et al., (2019)27
|
Emergency homeless shelter, United States
|
People experiencing homelessness (n=44);
Gender: 34% female;
Age: 48.24 ±11.46
|
Information/advice support; individual sessions; group sessions; NRT (gum, patches; lozenges)Choice of ENDS device; 4mg gum; 14mg and 21mg patch; 4mg lozenges
|
14 weeks
|
Dawkins (2020)28
|
Homeless shelter, United Kingdom
|
People experiencing homelessness
(n=80)
Gender: 35% female;
Age: 42.66±10.79.
|
ENDS device, 4 week supply of eliquid
|
24 weeks
|
Dickson Spillman (2014)29
|
Gay health clinic, Switzerland
|
Men who have sex with men (n=70);
Gender: 0% female;
Age: 42.96 ±9.66.
|
Seven weekly sessions facilitated by peers. Multiple different forms of NRT
|
6 months
|
Hickling et al., (2019)30
|
Pre/post feasibility study, Community health team referrals, England
|
People with serious mental illness- psychotic disorder (n=50);
Gender: 24% female;
Age: 39 ±10.7
|
6 week intervention, ENDS
|
24 weeks
|
Johnson et al., (2020)31
|
Feasibility study,
|
People with severe mental illness (n=34)
Gender: 47% female;
Age: 50% below 40 years old.
|
2 weeks of NRT (patches)
|
3 months
|
Mikhailovich and Morrison (2008)32
|
Evaluation
|
Aborginal people; people with serious mental illness
People who uses drugs
(n=63)
Gender: not reported;
Age: not reported .
|
Tailored NRT
|
6 months
|
Pakhale 33
|
A feasibility mixed methods prospective
cohort study, Community research office, Canada
|
People who use drugs (n=80)
Gender: 30% female;
Age: 43.8.
|
6 month intervention; access to counselling and NRT
|
6 months
|
Richmond et al (2006)34
|
Pilot study, prison, Australia
|
People who are incarcerated(n=330);
Gender: 0% female;
Age: 35±10.
|
NRT (patch) 21 mg/day for six weeks, 14 mg/day for two weeks and 7 mg/day for two weeks
|
6 months
|
Saxon, McGuffin and Walker, (1997)35
|
Substance use treatment centre, United States
|
People who use alcohol and other drugs (n=49)
Gender: 4.1% female;
Age: 44.1 ± 7.8
|
NRT (patch) 21mg nicotine
|
6 weeks
|
Scheibein et al (2020)36
|
Feasibility study, homeless services, Ireland
|
People experiencing homelessness (n=9)
Gender: 28.57, female;
43.89± 7.36.
|
ENDS device; choice of Nicotine 0,6,11,18 and 20mg liquid
|
3 months
|
Stein et al (2016)37
|
Methadone clinic, United States
|
People who use drugs- methadone (n=12);
Gender: 50% female
Age: 45.9±11.5
|
ENDS device
|
6 weeks
|
Valentine 201838
|
Veteran affairs health system
|
Veterans attending mental health clinics (n=43);
Gender: 7% female
Age: 56.9±8.0
|
ENDS device
|
4 week
|
White (2016)39
|
Recovery community, Iran
|
People in alcohol recovery (n=100);
Gender: 11%, female
Age:40.1±10.9
|
prolonged
nicotine replacement therapy (NRT) with a broad spectrum of
psychosocial supports
|
1 year
|
3.3. Controlled trials (CTs)
3.3.1. Summary of controlled trials
The results from the included CTs are summarized in Table 3. The average length of follow up was 22.64 weeks with follow up ranging from 24 hours11 and 52 weeks.12 Studies took place in hospitals;11-12, 13outpatient clinics;14, 17-18, 23custodial settings;15,22a HIV clinic;16a drug treatment service;20 an Aboriginal health service19 and in a university setting.21
Results of controlled trials
Three RCTs reported on interventions with people who use drugs.12, 18, 20. At 12 and 26 weeks, a 36-week intervention with alcohol dependent patients in early recovery, using 16 sessions of Cognitive Behaviour Therapy (CBT) + Nicotine Replacement Therapy (NRT) was found to have a statistically significant impact on the 7-day point prevalence quit rate (both p = .03).12 However, this effect was no longer statistically significant at 38 or 52 weeks (ibid.). A study using an ENDS device18 found that the intervention was effective in reducing self-reported cigarette consumption with a biochemically verified (<8ppm CO) end of treatment smoking abstinence rate of 8.6% (intent-to-treat) and 10.7% for the per protocol group (n=28). Twenty-eight percent of those who completed the program reported a 50% reduction in cigarette consumption, however, this did not seem to have been corroborated by biochemical verification (ibid.). A NRT based intervention, which included a computerised feedback component, did not increase motivation to quit or increase long term abstinence.20
Two RCTs reported mental health outcomes of interventions with people living with mental illness. One study11 investigated the effect of NRT in reducing agitation in people living with schizophrenia as measured by the Mean Agitated Scale score over a 24-hour period. The mean Agitated Behaviour Scale score for the group receiving NRT was 33% lower at 4 hours and 23% lower at 24 hours than the placebo group (ibid.). Another study,13 also in an inpatient unit, compared the effect of patches, gum and inhalers, and found that the groups using inhalers or gum had significantly reduced psychiatric symptom severity symptoms at weeks 4 and 12 with the inhaler group showing the greatest reductions. Only the inhaler group was found to have a significant reduction in CO at weeks 4 and 12 (P < 0.001 and P = 0.032, respectively) but both the nicotine inhaler and the patch groups showed significant decrease in nicotine withdrawal symptoms from baseline at both weeks 4 and 8 (ibid.).
Two studies considered NRT pre-loading (pre supplementation with nicotine) to increase treatment efficacy for people living with mental illness.14, 17 One study14 which investigated the effect of NRT pre-loading with a 21mg nicotine patch found that those receiving the intervention were more likely to be abstinent (3 months 8.5% vs. 1.0%, respectively, p = .01) and were more likely to accept four or more cessation sessions (50.8% vs 29.2%, respectively, p < .001). However, a study17 exploring NRT pre-loading with another population of people with serious mental illness found no statistically significant reduction in smoking or craving during the preloading period and no differences in terms of 6 week or 6-month abstinence when compared to the control group.
A 10 week group intervention with NRT with women in prison found that point prevalence quit rates for the intervention group, as compared to a waitlist control, were 18% at end of treatment, 17% at 3-month follow-up, 14% at 6-month follow-up, and 12% at 12- month follow-up.15 An intervention with men in prison found that Motivational Interviewing (MI) + NRT was more effective than MI only in reducing smoking as biochemically validated with CO (p = 0.02).22
An intervention with pregnant Indigenous women with online sessions, NRT and CO monitoring, evaluated through a step cluster design, led to biochemically validated (<6ppm) 12 week 7-day point-prevalence abstinence in 13.% (n=3) of participants.19 A study exploring the effect of NRT contacts with people living with HIV found that the number of contacts was significantly associated with 6 month abstinence.23 Another study with people living with HIV found that a 8 week NRT + counselling intervention found that the treatment group smoked less cigarettes per day(η2 = .07; p = .13); had lower physical nicotine dependence(η2 = .18, p = .01) and lower smoking urges (η2 = .16, p = .01).16
A novel study21 compared two very low nicotine cigarettes with one higher nicotine cigarettes in an intervention with individuals with affective disorders, individuals with opioid use disorder and women smokers with socioeconomic disadvantage. The very low nicotine cigarettes led to reductions in cigarettes per day but there were no significant differences between the two very low nicotine cigarette types (ibid.).
Quality Appraisal of Controlled Trials
The overall quality of the controlled trials, as evaluated using the JBI Appraisal Tool, was found to be low with an average of 5.92/13 with a range from 3-9/13. Almost fifty percent of studies did not use or did not clearly describe true randomisation procedures (6/13 studies). All studies did not clearly describe concealing allocation to the treatment group (13/13 papers). Many of the studies (9/13 studies) reported that the treatment groups were similar at baseline. Only two of the 13 studies, clearly outlined that their participants were blind to treatment assignment whilst only one study clearly outlined that those delivering treatment were blind to treatment allocation; four studies stated assessors were blind to treatment. Most studies (11/13 studies) clearly outlined that treatment groups were treated identically other than the intervention of interest. Six of the studies completed follow up or adequately explained loss to follow up. Seven of the studies analysed participants in the groups to which they were randomised. Most studies (12/13) clearly described that outcomes were measured in the same way between treatment groups. Four of the studies delineated how their measurements were performed reliably. Five of the studies accurately described how they had used the correct statistical techniques. Eight of the studies utilised an appropriate trial design and satisfactorily reported any deviations from the trial design.
3.3. Uncontrolled trials
3.3.1. Summary of uncontrolled trials
The results from the included uncontrolled trials are summarized in Table 3. The average length of follow up was 20 weeks, ranging from 4 weeks38 and 52 weeks.39 Studies took place in homeless services;25, 27-28, 36 drug treatment services;35,37,39 outpatient clinic;24,26 prison;34 a gay health clinic;29 a community health clinic30and a veteran health clinic.38
Summary of Uncontrolled Trial Results
An intervention with people living with HIV consisting of 5 sessions of smoking cessation counselling with NRT led to 28% biochemically verified abstinence from smoking at 6 months.24 An intervention with men who have sex with men consisting of 7 weekly sessions facilitated by peers with NRT was found to be significantly associated with point prevalence abstinence (p=0.00) with 38.6% reported smoking abstinence over the previous 7 days at 6 months.29 A study which evaluated a decreasing regiment of NRT patches with people in prison was found to lead to biochemically validated point prevalence abstinence and continuous abstinence rates of 26% and 22% respectively.34 A partially student run intervention which utilised NRT with people experiencing homelessness led to 13.7% of participants contacting the smoking cessation line.25 A small scale study, using NRT patches, with people accessing mental health services found that the intervention led to a reduction in the number of daily cigarettes number of cigarettes, dependency levels and average weekly expenditure on tobacco at 3 months.31
Several studies evaluated interventions related to ENDS devices. An intervention with people experiencing homelessness using information advice, group sessions, NRT and providing a choice of ENDS device found an 18% increase in odds of reporting 7-day, biochemically verified, point-prevalence abstinence.27 All study participants reporting abstinence used an ENDS device and those using an ENDS device were found to have a 44% reduction in smoking intensity and a 1.2-point reduction in dependence (ibid.) Another study, with people experiencing homelessness and using an ENDS device, found biochemically validated sustained abstinence 3/48 (6.25%) at 24 weeks in the treatment group compared to 0/32 (0%) for the usual care group.28
A small ENDS intervention with people experiencing homelessness found a statistically significant decrease in reported cigarettes smoked and decrease in Fagerstrom scores (p < 0.001).36 However, decreases in biochemically validated abstinence were not statistically significant (ibid.). A six week ENDS intervention with people with serious mental illness was found to lead to a (≥50%) reduction in cigarettes consumed per day between baseline and week 6 (p<0.001).30 Another ENDS based intervention with veterans with mental health issues was found to lead to significant reductions in breath CO ( p < 0.02) and self-reported cigarettes smoked ( p < 0.001).38
A study evaluating a 21mg NRT patch intervention with people using drugs stated that seven subjects (14.3%) self-reported tobacco abstinence at 21 days, and 5 (10.2%) self-reported abstinence as outpatients at 6 weeks.35 An ENDS-based intervention, with a population recruited from a methadone clinic, was found to lead to a reduction in the number of cigarettes smoked at 3 weeks (P < 0.001), 5 weeks P < .001) and 9 weeks (P <0 .01)37.Similarly , a NRT intervention with people in a residential treatment centre reported extremely high in-treatment (85%) and posttreatment (99%) abstinence rates.39
Mental health and other benefits are reported by several studies. A study with people experiencing homelessness, using an ENDS device, found that GAD-7, PHQ-9 and AUDIT scores declined from baseline.28 Another study using an ENDS device with people experiencing homelessness found a decrease in “poor concentration” over the treatment period.36 An intervention using NRT and weekly peer led sessions with men who have sex with men was found to increase mental health between baseline and follow up (p= 0.00).29 However, there was no difference between depression and anxiety scores between those who had relapsed and those who did not (p > 0.05). A community-based study with people who use drugs found that an intervention including a NRT component led to a considerable reduction in self-reported illicit substance use (18.8%), including a reduction in the opioids heroin (6.3%), fentanyl (2.6%) and Oxycontin (3.8%).33 Other reported benefits included improved health, return to work and greater community engagement (ibid.)
Quality Appraisal of Uncontrolled studies
The overall quality of the uncontrolled trials, using the JBI Appraisal Tool, was found to be low with an average of 2.5/9 with a range from 0-6/9. The cause and effect of the study was clearly articulated in most studies (11/16 studies). Only one study included a control group and there were differences between the treatment and control group. Four studies had completed follow up and/or used intention to treat analysis. Four studies included comparisons but only one clearly outlined that outcomes were measured in the same manner. No study clearly outlined that measurements were performed in a reliable way. Eight of the studies clearly outlined that they had used the appropriate statistical test.
Controlled studies
|
Study Primary or secondary aim
|
Smoking outcomes
|
Other outcomes
|
Appraisal
score
|
Allen et al (2011)11
|
To investigate the effect of NRT in the reduction of agitation and aggression
|
Not applicable
|
M1: Mean Agitated Behaviour Scale score for NRT group was 33% lower at 4 hours and 23% lower at 24 hours than the placebo group
|
8/13
|
Carmody (2013)12
|
To investigate the efficacy of an intensive tobacco cessation intervention for alcohol-dependent smokers in early recovery.
|
At 12 and 26 weeks the 7 day point prevalence quit rates were significantly higher in the intensive care group (both p = .03).
However, the quit rates were not statistically significant at 38 or 52 weeks
|
Verified 30-day alcohol abstinence were not statistically significant at any of the follow up points.
|
3/13
|
Chan et al., (2020)13
|
To compare effectiveness and acceptability of 3 different forms of NRT
|
Nicotine inhaler group showed statistically significant reduction in CO level from baseline at both weeks 4 and 8 (P < 0.001 and P = 0.032, respectively).
The nicotine inhaler and the patch group showed significant decrease in nicotine withdrawal symptoms from baseline at both weeks 4 and 8.
|
The nicotine inhaler and the gum groups showed significant decrease in psychiatric symptom severity from baseline at both weeks 4 and 8.
|
8/13
|
Christiansen et al. (2017)14
|
To test a pre-cessation intervention
|
Smokers receiving the intervention were more likely to be abstinent at 3 months 8.5% vs. 1.0%, respectively, p = .01).
More likely to accept 4 or more cessation sessions 50.8% vs 29.2%, respectively, p < .001) b
|
|
7/13
|
Cropsey (2008)15
|
To test the efficacy of a combined pharmacologic and behavioral smoking cessation intervention
|
18% at end of
treatment, 17% at 3-month follow-up, 14% at 6-month follow-up, and 12% at 12-
month follow-up
|
|
5/13
|
Cropsey (2014)16
|
To evaluate the acceptability,
feasibility, and effects of a Screening, Brief Intervention, and Referral for Treatment (SBIRT) model i
|
Treatment group smoked fewer cigarettes per day(η2 = .07; p = .13); had lower physical nicotine dependence(η2 = .18, p = .01) ; lower smoking urges (lower smoking urge (η2 = .16, p = .01)
|
|
8/13
|
Dennis et al., (2016)17
|
To evaluate the efficacy of supplemental nicotine patch-preloading among smokers
|
: Nicotine patch-preloading failed to reduce smoking or craving during the preloading phase
no differences were observed between the treatment conditions for time to lapse, 6-week abstinence, or 6-month abstinence.
|
No effect on smoking-associated relief from PTSD symptoms and negative affect.
|
9/13
|
Felicione et al.,(2018)18
|
To examine the
feasibility, acceptability, and effect of e-CIG on smoking behavior among smokers with opiate use disorder.
|
S1: End of treatment smoking abstinence was 8.6% (intent-to-treat; n=35) and 10.7% for per protocol group (n=28). 28% of those who completed the program were able to achieve a 50% reduction to their baseline cigarette consumption.
|
|
5/13
|
Gould et al., (2019)19
|
To explore the feasibility and acceptability of a) a co-designed multi-component intervention for HPs at Aboriginal Medical Services (AMSs) in culturally-targeted pregnancy-specific smoking cessation care
|
CO validated (<6ppm) Self-reported 12-week 7-day point-prevalence abstinence was 13.6% (n = 3)
|
|
4/13
|
Higgins et al., (2020)20
|
To examine whether very low-nicotine-content (VLNC) cigarettes decrease smoking rates and dependence severity
|
At week 12, mean (SEM) CPD decreased to 17.96 (0.98) CPD
in the 0.4mg/g group and to 19.53 (1.07) CPD in the 2.4mg/g group, both of which were significantly
different from the 15.8 mg/g group (25.08 [1.08] CPD at week 12) but not each other (0.4 mg/g)
Fagerstrom Dependence Test Scores were significantly different between the very low nicotine cigarettes and the higher nicotine cigarettes
|
|
8/13
|
Hall (2018)21
|
To evaluate an intervention to increase cigarette abstinence rates
|
S1: Did not increase long term abstinence
D1: Increased motivation to quit
|
|
5/13
|
Jalali et al., (2015)22
|
To compare the effects of MI based treatment and its combination with NRT on smoking in prison population.
|
S2: Lower CO with MI with NRT group (p = 0.02)
|
|
3/13
|
Stanton et al., (2009)23
|
To examine 6 month abstinence from Positive PATHS trial
|
S1: Number of NRT contacts is sig associated with abstinence at 6 month
Total effect of NRT contacts suggested an increase in the regression adjusted odds of smoking abstinence by 35% per additional contact
|
D1:Sig direct effect of NRT contacts mediators: smoking self-efficacy and smoking decisional balance.
O1: The mean number of total NRT-related contacts per patient did not differ significantly between the SC and ME groups
|
4/13
|
Uncontrolled
|
Study Primary or secondary aim
|
Smoking outcomes
|
Other outcomes
|
Appraisal
score
|
Balfour (2016)24
|
To examine the effectiveness of a
specifically tailored 5-session smoking cessation counselling programme
|
6-month follow-up, 28% of participants demonstrated biochemically
verified abstinence from smoking
|
Lower depression than at baseline but statistically significant (p= 0.058)
|
3/9
|
Buckley et al., (2017)25
|
To describe a professional and student run program;
|
19 (13.7%) successfully contacted the smoking cessation
quitline.
|
|
1/9
|
Cioe et al., (2019)26
|
To examine the acceptability and health-related effects of ENDS
|
At week 8, cigarettes per day (CPD) were reduced by more than 80%, with reduction maintained at
week 12 (p’s < .001). Cigarette dependence scores were 40% lower at week 8 than at baseline (p < .001).Mean CO decreased significantly
from BL to week 8 (p < .05) and remained significantly lower at week 12 (p < .001)
|
|
4/9
|
Collins et al (2019)27
|
To explore the feasibility, acceptability and HR QoL outcomes
|
S1: 18% increase in odds of reporting 7-day, biochemically verified, point-prevalence abstinence. All participants reporting abstinence used ENDS.
Reductions in cigarette dependence (45%), frequency (-29%), and intensity (78%; ps < .05).
Participants who used ENDS experienced an additional 44% reduction in smoking intensity and a 1.2-point reduction in dependence
|
Health related quality of life outcomes were not statistically significant (ps > .06).
|
3/9
|
Dawkins (2020)28
|
To assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters to inform a possible future larger trial
|
CO validated sustained abstinence at 24 weeks was 3/48 (6.25%) and 0/32 (0%) respectively for the EC and UC arms
|
GAD-7, PHQ-9 and AUDIT scores declined from baseline
|
6/9
|
Dickson Spillman (2014)29
|
To examine if the impact of the intervention to
facilitate smoking cessation and improve other health
outcomes as well as to assess its attractiveness to the
target population
|
S1: Point prevalence abstinence increased significantly (p-0.00)
At 6 month 28.6% reported smoking abstinence over the previous 7 days
|
M1: Mental health increased between baseline and follow up (p=.00)
There was no difference between depression and anxiety scores between those who had relapsed and those who did not (p > .05).
|
4/9
|
Hickling et al (2019)30
|
To investigate the utility of electronic cigarettes (e-cigarettes) as a harm reduction intervention
|
S1: (≥50%) reduction in cigarettes consumed per day between baseline and week 6 (F(2.596,116.800)=25.878,p<0.001)
|
|
3/9
|
Johnson et al., 202031
|
To test a new program for helping smokers with severe mental illness to reduce their tobacco use, together with
determining the feasibility of such research in community mental health settings
|
reduced their number of daily cigarettes, dependency levels and average weekly expenditure on tobacco
|
|
1/9
|
Mikhailovich and Morrison (2008)32
|
To valuate a NRT tailored program
|
Low level of success
|
|
0/9
|
Pakhale 33
|
To determine the feasibility of a Community Based Participatory Tobacco Dependence Strategy
|
Mean reduction of 11.2 cigarettes at 6months (P=0.0001).
|
considerable reduction in self-reported illicit
substance use (18.8%), including a reduction in the opioids
heroin (6.3%), fentanyl (2.6%) and Oxycontin (3.8%).
Other reported benefits included improved health, return to work and greater community engagement
|
2/9
|
Richmond et al., (2006)34
|
To determine the feasibility and effectiveness of a multi-component smoking cessation
|
biochemically validated point prevalence
and continuous abstinence rates were 26% and 22% respectively
|
|
2/9
|
Saxon, McGuffin and Walker, (1997)35
|
To undertake an open, pilot evaluation of
transdermal nicotine for cigarette smokers
|
Seven subjects (14.3%) self-reported tobacco
abstinence at 21 days, and 5 (10.2%) self-reported abstinence as outpatients at 6 weeks
|
|
2/9
|
Scheibein et al., (2020)36
|
To explore the efficacy, challenges and opportunities of using electronic nicotine delivery systems (ENDS) to support cessation of tobacco smoking
|
Self-reported reductions in cigarette consumption were found to be statistically significant (p < 0.001)
Reductions in carbon monoxide measurements were not statistically significant.
Decreases in Fagerström Nicotine Dependence Test were statistically significant (p = 0.001), but decreases in MPSS “urge to smoke” and “strength of urges” composite scores were not.
|
|
2/9
|
Stein et al., (2016)37
|
To conduct a small open pilot
trial on the use of e-cigarettes as a smoking cessation
|
S1: Mean reductions in CPD were −12.4 (95% confidence interval [CI]: −15.0, −9.9; P < .001), −14.8 (95% CI: −17.4, −12.2; P < .001), −13.9 (95% CI: −16.6, −11.2), and −10.8 (95% CI: −13.4, −8.2; P < .01) at the 3-, 5-, 7-, and 9-week assessments, respectively.
|
|
3/9
|
Valentine 201838
|
To examine the impact of e-cigarette use on combustible tobacco use, as well as on the readiness to quit smoking and changes in nicotine dependence
|
Significant reductions in breath CO (9.3 ppm to 7.3 ppm, p < 0.02) and CPD (from 16.6 to 5.7, p < 0.001
|
|
2/9
|
White (2016)39
|
To explores the introduction of a smoking cessation intervention
|
High in-treatment (85%)
and posttreatment (99%) abstinence rates
|
|
1/9
|