Effectiveness of education based strategies for smoking cessation: a meta analysis

Background: World Health Organization has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about six million people across the world each year with many of these deaths occurring prematurely. This total includes about 600,000 people are also estimated to die from the effects of second-hand smoke.1 The provision of educational interventions in combination with systematic outreach practice-based support could be an effective strategy to engage smokers in smoking cessation activities2. As the evidence for harmful effects of tobacco use has mounted, epidemiological research has progressed from simply identifying health risks associated with smoking to more detailed studies of the long-term effects of different smoking behaviours on mortality and morbidity.3. Search methods: Electronic database searches were conducted using the following keywords; smoking cessation education intervention randomized controlled trials. Studies were included if they were used- (1) randomized or controlled designs, (2) controlled before and after trials designs, and (3) designs that presented objective and (4) interpretable measures of smokers behaviour and smokers quit rates, (5) articles written in the English language. An effect size (ES) was calculated for every outcome measure reported, risk ratio, calculated as: (number of quitters in intervention group/ number randomized to intervention group) / (number of quitters in control group/ number randomized to control group).4 Meta-analysis is performed using a Mantel-Haenszel fixed-effect method to estimate a pooled risk ratio with 95% confidence intervals.5 Results: A total of 26 trials met the inclusion criteria for comparisons in this review. The study failed to detect evidence that education based strategies was more effective than a similar intensity of non educational format. There was limited evidence that the addition of Education Based interventions (EBIs) to other forms of treatment, such as nicotine replacement, produced extra benefit. Conclusions: There is not enough evidence to evaluate whether Education Based interventions (EBIs) are more effective than other non educational intervention. Identifying the most effective and cost-effective education based intervention for different populations of smokers is still an area for research. However Education Based interventions (EBIs) are likely to be effective when used independent of pharmacotherapy. Keywords: Smoking, Cessation, Education, Intervention Studies, Randomized Controlled Trials, Meta Analysis.