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Systematic review of the effectiveness of stage based interventions to promote smoking cessation

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Riemsma, R. P., Pattenden, Jill, Bridle, Christopher, Sowden, Amanda J., Mather, Lisa, Watt, Ian, 1957- and Walker, Anne. (2003) Systematic review of the effectiveness of stage based interventions to promote smoking cessation. BMJ, Vol.326 (No.7400). ISSN 0959-535X

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Official URL: http://dx.doi.org/10.1136/bmj.326.7400.1175

Abstract

Objective To evaluate the effectiveness of interventions using a stage based approach in bringing about positive changes in smoking behaviour. Design Systematic review. Data sources 35 electronic databases, catalogues, and internet resources (from inception to July 2002). Bibliographies of retrieved references were scanned for other relevant publications, and authors were contacted if necessary. Results 23 randomised controlled trials were reviewed; two reported details of an economic evaluation. Eight trials reported effects in favour of stage based interventions, three trials showed mixed results, and 12 trials found no statistically significant differences between a stage based intervention and a non-stage based intervention or no intervention. Eleven trials compared a stage based intervention with a non-stage based intervention, and one reported statistically significant effects in favour of the stage based intervention. Two studies reported mixed effects, and eight trials reported no statistically significant differences between groups. The methodological quality of the trials was mixed, and few reported any validation of the instrument used to assess participants’ stage of change. Overall, the evidence suggests that stage based interventions are no more effective than non-stage based interventions or no intervention in changing smoking behaviour. Conclusions Limited evidence exists for the effectiveness of stage based interventions in changing smoking behaviour.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Smoking cessation -- Great Britain, Preventive health services -- Great Britain
Journal or Publication Title: BMJ
Publisher: BMJ Group
ISSN: 0959-535X
Date: 29 May 2003
Volume: Vol.326
Number: No.7400
Identification Number: 10.1136/bmj.326.7400.1175
Status: Peer Reviewed
Access rights to Published version: Open Access
Funder: Great Britain. National Health Service (NHS)
References: 1 NHS Centre for Reviews and Dissemination. Smoking cessation: what the health service can do. Effectiveness Matters 1998;3:1-4. 2 Woolacott N, Jones L, Forbes C, Mather L, Sowden A, Song F, et al. The clinical effectiveness and cost-effectiveness of bupropion and nicotine replacement therapy for smoking cessation: a systematic review and economic evaluation. Health Technol Assess 2002;6(16):1-245. 3 National Institute for Clinical Excellence. Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation. London: NICE, 2002. (Technology Appraisal Guidance No 39.) 4 Office for National Statistics. Living in Britain: results from the 1998 general household survey. London: Stationery Office, 2000. 5 Brown R, Larkin J, Davis R. Current concepts in the management of smoking cessation: a review. Am J Manag Care 2000;6:394-404. 6 Cinciripini P, McClure J. Smoking cessation—recent developments in behavioral and pharmacologic interventions. Oncology 1998;12:249. 7 Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol 1992;47:1102-14. 8 Prochaska JO, Velicer WF, DiClemente CC, Fava J. Measuring processes of change: applications to the cessation of smoking. J Consult Clin Psychol 1988;56:520-8. 9 Sutton S. Transtheoretical model of behaviour change. In: Baum A, Newman S, Weinman J, West R, McManus C, eds. Cambridge handbook of psychology, health and medicine. Cambridge: Cambridge University Press, 1997. 10 Sutton S. A critical review of the transtheoretical model applied to smoking cessation. In: Norman P, Abraham C, Conner M, eds. Understanding and changing health behaviour: from health beliefs to self-regulation. Amsterdam: Harwood Academic Press, 2000. 11 Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983;51:390-5. 12 West R, McEwen A. Smoking cessation training in England: a survey of trainers and health authorities. A report to the Health Development Agency, 2001. www.hda-online.org.uk/downloads/pdfs/ smoking_cess_training.pdf (accessed 14 May 2003). 13 Department of Health. Statistics on smoking cessation services in England, April 2001 to March 2002. London: Department of Health, 2002. (Bulletin 2002/25 ed.) 14 Smoking kills.A white paper on tobacco. London: Stationery Office, 1998. 15 Sutton S. Interpreting cross-sectional data on stages of change. Psychol Health 2000;15:163-71. 16 Bunton R, Baldwin S, Flynn D. The stages of change model and its use in health promotion: a critical review. Edinburgh: Health Education Board for Scotland, 1999. 17 Bunton R, Baldwin S, Flynn D, Whitelaw S. The ‘stages of change’ model in health promotion: science and ideology. Crit Public Health 2000;10: 55-70. 18 Whitelaw S, Baldwin S, Bunton R, Flynn D. The status of evidence and outcomes in stages of change research. Health Educ Res 2000;15:707-18. 19 NHS Centre for Reviews and Dissemination. Undertaking systematic reviews of research on effectiveness:CRD’s guidance for carrying out or commissioning reviews, 2nd ed. York: NHS Centre for Reviews and Dissemination, 2001. 20 Whitehead M. How useful is the ‘stages of change’ model? Health Educ J 1997;56:111-2. 21 Ashworth P. Breakthrough or bandwagon? Are interventions tailored to stage of change more effective than non-staged interventions? Health Educ J 1997;56:166-74.
URI: http://wrap.warwick.ac.uk/id/eprint/4303

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