Osong Public Health Res Perspect.  2021 Aug;12(4):244-253. 10.24171/j.phrp.2021.0017.

Behavioral therapy and pharmacotherapy for relapse prevention in abstinent smokers: a rapid review and meta-analysis for the Korea Preventive Service Task Force

Affiliations
  • 1Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
  • 2Department of Family Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
  • 3Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
  • 4Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
  • 5Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea

Abstract


Objectives
This study aimed to assess the effectiveness of relapse prevention interventions involving behavioral and pharmacological treatment among abstinent smokers.
Methods
This rapid review was conducted using MEDLINE, Cochrane CENTRAL, CINAHL, Embase, KMbase, and KoreaMed to identify studies published until June 20, 2020. The participants were abstinent smokers who quit smoking on their own, due to pregnancy, hospitalization, or by participating in a smoking cessation program. We found a systematic review that fit the objective of this study and included 81 randomized controlled trials (RCTs). Studies that did not present information on smoking cessation status, had no control group, or used reward-based interventions were excluded. Random effect and fixed effect meta-analyses were used to estimate the relative risk (RR) and 95% confidence interval (CI). In subgroup analyses, differences between subgroups were verified based on the participant setting, characteristics, intervention type, and intensity.
Results
Following screening, 44 RCTs were included in the meta-analysis. The review reported no differences in the success rate of relapse prevention between the behavioral interventions. Pharmacotherapy interventions showed higher success rates (RR, 1.15; 95% CI, 1.05−1.26; I2=40.71%), depending on prior abstinence duration and the drug type. Conclusions: The results indicated that pharmacotherapy has a significant effect on preventing relapse among abstinent smokers.

Keyword

Behavior therapy; Drug therapy; Randomized controlled trial; Rapid review; Relapse prevention; Smoking cessation
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