References
An evidence-based guide to smoking cessation therapies
Abstract
Despite a general decline in smoking in the UK, prevalence remains high in certain groups such as young adults, pregnant women, those who have a mental Illness and those from socio-economically disadvantaged backgrounds. These groups are also more likely to benefit from targeted smoking cessation interventions. Clinical contact between health professionals and patients who smoke creates an opportunity for offering cessation interventions and to reduce smoking-related harm. This article summarises evidence reported in high-quality systematic reviews on smoking cessation interventions that could be offered by health professionals coming in to contact with patients who smoke. The evidence presented here suggests that brief advice by a health professional is beneficial in achieving smoking cessation and so is intensive behavioural support, alone or in combination with pharmacotherapies (nicotine replacement therapies [NRTs], bupropion and varenicline). Pharmacotherapies are also effective individually in achieving smoking cessation; a combination of NRTs (oral or skin patch) can be particularly helpful among highly dependent smokers. Pharmacotherapies in combination with behavioural support delivered in healthcare settings are more effective than when used alone and delivered in community settings, respectively. Electronic cigarettes are also effective in achieving smoking cessation and are more effective than NRT.
In the 1970s, around 50% of the UK’s population smoked tobacco in one form or another. The proportion dropped rapidly to a third by the 1990s and has since been declining at a slower rate (Office for National Statistics (ONS), 2021). Smoking prevalence in the UK has now fallen to 13.3% (Action on Smoking (ASH), 2021). However, this reduction is not evident across socio-economic groups. Unemployed adults (25.7%) and people who have no qualifications (28.2%) make up a higher proportion of current smokers (ONS, 2021), with smoking one of the principal causes of the health divide across the socio-economic strata. Higher smoking prevalence is also observed in people with a mental Illness (40%), who are more than twice as likely to smoke than the general population (Royal College of Physicians, 2013).
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