The Effectiveness of Smoking Cessation Interventions in Rural and Remote Populations: Systematic Rev
Friday, July 15, 2022
Posted by: Natalia Gromov
Vance L, Glanville B,
Ramkumar K, Chambers J, Tzelepis F.
The Effectiveness of
Smoking Cessation Interventions in Rural and Remote Populations: Systematic
Review and Meta-analyses.
[published online ahead of print, 2022 Jun 27]. Int J Drug Policy.
2022;106:103775. doi:10.1016/j.drugpo.2022.103775
Background. Rural
and remote residents are more likely to smoke tobacco than those in major
cities. However, they may experience unique systemic, provider, and individual
barriers to accessing smoking cessation treatments, including distance and
limited resources. Understanding the effectiveness of smoking cessation
interventions in this population is important due to higher smoking-related disease
burden and death compared to those in major cities.
Methods. Medline,
EMBASE, Scopus, PsychINFO, and Cochrane Library were searched until 19-02/2021.
Inclusion criteria were randomised controlled trials (RCTs), cluster RCTs,
randomised trials, or cluster randomised trials investigating behavioural
interventions and pharmacotherapies for smoking cessation in rural and remote
populations compared with a control or another smoking cessation treatment; and
published in English. Given there is no internationally-standardised rurality
index, definitions of 'rural' and 'remote' used by authors of studies were
applied to reflect their country. Exclusion criteria were studies of
non-combustible smoking cessation; and studies with urban participants in the
sample. Two reviewers independently screened records for eligibility, extracted
data from studies utilising a modified Cochrane Effective Practice and
Organisation of Care Group form, and rated methodological quality using the
Quality Assessment Tool for Quantitative Studies.
Results. Sixteen
studies were included. Meta-analysis revealed a statistically significant
treatment effect of individual face-to-face counselling on smoking cessation
(RR 2.35, 95% CI 1.16-4.76, I2=0%) in rural and remote populations.
There was no statistically significant treatment effect for nicotine
replacement therapy (RR 2.97, 95% CI 0.84-10.53, I2=47%),
telephone-counselling (RR 1.69, 95% CI 0.56-5.06, I2=62%), and
community-based multiple-interventions (RR:1.57, 95% CI 0.89-2.78, I2=85%).
Certainty of evidence was rated very low for each meta-analysis.
Conclusion. Despite
limited resources in rural and remote settings, individual face-to-face
counselling for smoking cessation appears promising. Given the limited number
of studies, further research about the effectiveness of smoking cessation
interventions in rural and remote populations is warranted.
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