Distance-based strategy cuts smoking in cancer survivors

Distance-based interventions to assist smoking cessation (SC) appear to be effective among cancer survivors, reports a recent meta-analysis.

Accessing the databases of PubMed, Embase, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials, researchers retrieved 17 studies corresponding to 3,796 survivors (mean age, 52.8±14.3 years; 58.6 percent female). Nine studies focused on smoking cessation alone, while the remaining eight included alcohol moderation interventions in multibehavioural intervention programme.

Within groups, 12 studies showed that distance-based interventions resulted in a significant drop in smoking (risk difference [RD], 0.23, 95 percent confidence intervals [CI], 0.13–0.33; p<0.0001). This was determined over a median follow-up time of 4.7 months, though heterogeneity of evidence was significant (p<0.0001).

Restricting analysis to only randomized controlled trials yielded the same result (RD, 0.23, 95 percent CI, 0.12–0.34; p<0.0001).

Subsequent disaggregation found that single-behaviour interventions were much more effective for smoking cessation (RD, 0.29, 95 percent CI, 0.19–0.39; p<0.0001) than multibehavioural approaches (RD, 0.13, 95 percent CI, –0.05 to 0.31; p=0.15). Removing one outlier improved evidence quality but did not attenuate the effect of single-behaviour interventions (RD, 0.32, 95 percent CI, 0.23–0.41; p<0.0001).

Ten studies included a control group. Pooled analyses of these showed that distance-based interventions supported smoking cessation significantly better (odds ratio [OR], 1.56, 95 percent CI, 1.13–2.15; p=0.007). Excluding one study, which was not randomized and controlled in design, did not meaningfully change the findings (OR, 1.50, 95 percent CI, 1.08–2.07; p=0.01).