Physician advice for smoking cessation

Lindsay F Stead, Diana Buitrago, Nataly Preciado, Guillermo Sanchez, Jamie Hartmann-Boyce, Tim Lancaster, Lindsay F Stead, Diana Buitrago, Nataly Preciado, Guillermo Sanchez, Jamie Hartmann-Boyce, Tim Lancaster

Abstract

Background: Healthcare professionals frequently advise people to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions.

Objectives: The aims of this review were to assess the effectiveness of advice from physicians in promoting smoking cessation; to compare minimal interventions by physicians with more intensive interventions; to assess the effectiveness of various aids to advice in promoting smoking cessation, and to determine the effect of anti-smoking advice on disease-specific and all-cause mortality.

Search methods: We searched the Cochrane Tobacco Addiction Group trials register in January 2013 for trials of interventions involving physicians. We also searched Latin American databases through BVS (Virtual Library in Health) in February 2013.

Selection criteria: Randomised trials of smoking cessation advice from a medical practitioner in which abstinence was assessed at least six months after advice was first provided.

Data collection and analysis: We extracted data in duplicate on the setting in which advice was given, type of advice given (minimal or intensive), and whether aids to advice were used, the outcome measures, method of randomisation and completeness of follow-up.The main outcome measure was abstinence from smoking after at least six months follow-up. We also considered the effect of advice on mortality where long-term follow-up data were available. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. People lost to follow-up were counted as smokers. Effects were expressed as relative risks. Where possible, we performed meta-analysis using a Mantel-Haenszel fixed-effect model.

Main results: We identified 42 trials, conducted between 1972 and 2012, including over 31,000 smokers. In some trials, participants were at risk of specified diseases (chest disease, diabetes, ischaemic heart disease), but most were from unselected populations. The most common setting for delivery of advice was primary care. Other settings included hospital wards and outpatient clinics, and industrial clinics.Pooled data from 17 trials of brief advice versus no advice (or usual care) detected a significant increase in the rate of quitting (relative risk (RR) 1.66, 95% confidence interval (CI) 1.42 to 1.94). Amongst 11 trials where the intervention was judged to be more intensive the estimated effect was higher (RR 1.84, 95% CI 1.60 to 2.13) but there was no statistical difference between the intensive and minimal subgroups. Direct comparison of intensive versus minimal advice showed a small advantage of intensive advice (RR 1.37, 95% CI 1.20 to 1.56). Direct comparison also suggested a small benefit of follow-up visits. Only one study determined the effect of smoking advice on mortality. This study found no statistically significant differences in death rates at 20 years follow-up.

Authors' conclusions: Simple advice has a small effect on cessation rates. Assuming an unassisted quit rate of 2 to 3%, a brief advice intervention can increase quitting by a further 1 to 3%. Additional components appear to have only a small effect, though there is a small additional benefit of more intensive interventions compared to very brief interventions.

Conflict of interest statement

None known

Figures

1
1
Effect of advice versus control (subgroups by intensity), Outcome: Smoking cessation at longest follow up
1.1. Analysis
1.1. Analysis
Comparison 1 Effect of advice versus control (subgroups by intensity), Outcome 1 Smoking cessation (at longest follow up).
2.1. Analysis
2.1. Analysis
Comparison 2 Effect of intensive advice versus minimal advice, Outcome 1 Smoking cessation (at longest follow up).
3.1. Analysis
3.1. Analysis
Comparison 3 Effect of number of advice sessions (direct comparison and subgroup analysis), Outcome 1 Smoking cessation (at longest follow up).
4.1. Analysis
4.1. Analysis
Comparison 4 Effect of aids as adjuncts to advice (direct comparison and subgroup analysis), Outcome 1 Smoking cessation (at longest follow up).
5.1. Analysis
5.1. Analysis
Comparison 5 Direct comparisons between types of advice, Outcome 1 Smoking cessation (maximum follow up).
6.1. Analysis
6.1. Analysis
Comparison 6 Advice versus tailored letters, Outcome 1 Smoking cessation (maximum follow up).
7.1. Analysis
7.1. Analysis
Comparison 7 Effect of advice on mortality and morbidity, Outcome 1 Number of events during 20 years follow up.
7.2. Analysis
7.2. Analysis
Comparison 7 Effect of advice on mortality and morbidity, Outcome 2 Number of events during 33 years follow up.

References

References to studies included in this review Ardron 1988 {published data only}

    1. Ardron M, MacFarlane IA, Robinson C, Heyningen C, Calverley PM. Anti‐smoking advice for young diabetic smokers: is it a waste of breath?. Diabetic Medicine 1988;5:667‐70. [MEDLINE: ]
Betson 1997 {published and unpublished data}
    1. Betson CL, Lam TH, Chung WH, Chung SF. A randomized controlled trial on smoking cessation in government out‐patient clinics in Hong Kong [Abstract]. Proceedings of the 10th World Conference on Tobacco or Health; 1997 Aug 24‐28; Beijing, China. 1997:113.
BTS 1990a {published data only}
    1. Research Committee of the British Thoracic Society. Smoking cessation in patients: two further studies by the British Thoracic Society. Thorax 1990;45:835‐40.
BTS 1990b {published data only}
    1. Research Committee of the British Thoracic Society. Smoking cessation in patients: two further studies by the British Thoracic Society. Thorax 1990;45:835‐40.
Burt 1974 {published data only}
    1. Burt A, Illingworth D, Shaw T, Thornley P, White P, Turner R. Stopping smoking after myocardial infarction. Lancet 1974;1(7852):304‐6.
Butler 1999 {published data only}
    1. Butler CC, Rollnick S, Cohen D, Bachmann M, Russell I, Stott N. Motivational consulting versus brief advice for smokers in general practice: a randomized trial. British Journal of General Practice 1999;49(445):611‐6.
Demers 1990 {published data only}
    1. Demers RY, Neale AV, Adams R, Trembath C, Herman SC. The impact of physicians' brief smoking cessation counseling: a MIRNET study. Journal of Family Practice 1990;31:625‐9. [MEDLINE: ]
Fagerström 1984 {published data only}
    1. Fagerström KO. Effects of nicotine chewing gum and follow‐up appointments in physician‐based smoking cessation. Preventive Medicine 1984;13:517‐27.
Gilbert 1992 {published data only}
    1. Gilbert JR, Wilson DM, Singer J, Lindsay EA, Willms DG, Best JA, et al. A family physician smoking cessation program: an evaluation of the role of follow‐up visits. American Journal of Preventive Medicine 1992;8:91‐5. [MEDLINE: ]
Haug 1994 {published data only}
    1. Haug K, Fugelli P, Aaro LE, Foss OP. Is smoking intervention in general practice more successful among pregnant than non‐pregnant women?. Family Practice 1994;11:111‐6.
Higashi 1995 {published data only}
    1. Higashi A, Ozasa K, Watanabe Y, Hayashi K, Aoike A, Kawai K, et al. [Efficacy of smoking cessation instruction for general smokers at an annual physical examination] [Japanese]. Nippon Koshu Eisei Zasshi 1995;42:313‐21. [MEDLINE: ]
Hilberink 2005 {published data only}
    1. Hilberink SR, Jacobs JE, Bottema BJ, Vries H, Grol RP. Smoking cessation in patients with COPD in daily general practice (SMOCC): six months' results. Preventive Medicine 2005;41(5‐6):822‐7.
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Jamrozik 1984 {published data only}
    1. Jamrozik K, Vessey M, Fowler G, Wald N, Parker G, Vunakis H. Controlled trial of three different antismoking interventions in general practice. British Medical Journal 1984;288:1499‐503. [MEDLINE: ]
Janz 1987 {published data only}
    1. Janz NK, Becker MH, Kirscht JP, Eraker SA, Billi JE, Woolliscroft JO. Evaluation of a minimal‐contact smoking cessation intervention in an outpatient setting. American Journal of Public Health 1987;77:805‐9. [MEDLINE: ]
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Lang 2000 {published data only}
    1. Lang T, Nicaud V, Slama K, Hirsch A, Imbernon E, Goldberg M, et al. Smoking cessation at the workplace. Results of a randomised controlled intervention study. Journal of Epidemiology and Community Health 2000;54:349‐54. [MEDLINE: ]
Li 1984 {published data only}
    1. Li VC, Kim YJ, Ewart CK, Terry PB, Cuthie JC, Wood J, et al. Effects of physician counseling on the smoking behaviour of asbestos‐exposed workers. Preventive Medicine 1984;13:462‐76. [MEDLINE: ]
Marshall 1985 {published data only}
    1. Marshall A, Raw M. Nicotine chewing gum in general practice: effect of follow up appointments. British Medical Journal 1985;290:1397‐8. [MEDLINE: ]
McDowell 1985 {published data only}
    1. McDowell I, Mothersill KJ, Rosser W, Hartman R. A randomized trial of three approaches to smoking cessation. Canadian Family Physician 1985;31:351‐5.
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Meyer 2008 {published data only}
    1. Haug S, Meyer C, Ulbricht S, Gross B, Rumpf HJ, John U. Need for cognition as a predictor and a moderator of outcome in a tailored letters smoking cessation intervention. Health Psychology 2010;29(4):367‐73.
    1. Haug S, Meyer C, Ulbricht S, Schorr G, Ruge J, Rumpf HJ, et al. Predictors and moderators of outcome in different brief interventions for smoking cessation in general medical practice. Patient Education & Counseling 2010;78(1):57‐64.
    1. Klein G, Ulbricht S, Haug S, Gross B, Rumpf HJ, John U, et al. Effects of practitioner‐delivered brief counseling and computer‐generated tailored letters on cigarettes per day among smokers who do not quit‐‐a quasi‐randomized controlled trial. Drug & Alcohol Dependence 2010;112(1‐2):81‐9.
    1. Meyer C, Ulbricht S, Baumeister SE, Schumann A, Ruge J, Bischof G, et al. Proactive interventions for smoking cessation in general medical practice: a quasi‐randomized controlled trial to examine the efficacy of computer‐tailored letters and physician‐delivered brief advice. Addiction 2008;103:294‐304.
    1. Meyer C, Ulbricht S, Schumann A, Hannover W, Hapke U, Rumpf HJ, et al. Interventions fostering the motivation to quit for smokers in general practice. Suchtmedizin in Forschung und Praxis 2003;5:134‐6.
    1. Ulbricht S, Baumeister SE, Meyer C, Schmidt CO, Schumann A, Rumpf HJ, et al. Does the smoking status of general practitioners affect the efficacy of smoking cessation counselling?. Patient Education & Counseling 2009;74(1):23‐8.
    1. Ulbricht S, Klein G, Haug S, Gross B, Rumpf HJ, John U, et al. Smokers' expectations toward the engagement of their general practitioner in discussing lifestyle behaviors. Journal of Health Communication 2011;16(2):135‐47.
Meyer 2012 {published data only}
    1. Meyer C, Ulbricht S, Gross B, Kastel L, Wittrien S, Klein G, et al. Adoption, reach and effectiveness of computer‐based, practitioner delivered and combined smoking interventions in general medical practices: a three‐arm cluster randomized trial. Drug and Alcohol Dependence 2012;121(1‐2):124‐32.
Morgan 1996 {published data only}
    1. Morgan GD, Noll EL, Orleans CT, Rimer BK, Amfoh K, Bonney G. Reaching midlife and older smokers ‐ tailored interventions for routine medical care. Preventive Medicine 1996;25:346‐54.
Nebot 1989 {published data only}
    1. Nebot‐Adell M, Soler‐Vila M, Martin‐Cantera C, Birules‐Pons M, Oller‐Colom M, Sala‐Carbonell E, et al. Effectiveness of the physician's advice to quit smoking: evaluation of the impact a year after the fact [Efectividad del consejo medico para dejar de fumar: evaluacion del impacto al ano de la intervencion]. Revista Clinica Española 1989;184:210‐5.
Ockene 1991 {published data only}
    1. Ockene JK, Kristeller J, Goldberg R, Amick TL, Pekow PS, Hosmer D, et al. Increasing the efficacy of physician‐delivered smoking interventions: a randomized clinical trial. Journal of General Internal Medicine 1991;6:1‐8. [MEDLINE: ]
    1. Ockene JK, Kristeller J, Pbert L, Hebert JR, Luippold R, Goldberg RJ, et al. The physician‐delivered smoking intervention project: can short‐term interventions produce long‐term effects for a general outpatient population?. Health Psychology 1994;13:278‐81. [MEDLINE: ]
Page 1986 {published data only}
    1. Page AR, Walters DJ, Schlegel RP, Best JA. Smoking cessation in family practice: the effects of advice and nicotine chewing gum prescription. Addictive Behaviors 1986;11:443‐6. [MEDLINE: ]
Pieterse 2001 {published data only}
    1. Pieterse ME, Boekema ER, Seydel ER, Wiegman O. Smoking cessation via the general practitioner: effects of a minimal contact intervention programme [abstract]. Patient Education and Counseling 1992;20:107.
    1. Pieterse ME, Seydel ER, Devries H, Mudde AN, Kok GJ. Effectiveness of a minimal contact smoking cessation program for Dutch general practitioners: A randomized controlled trial. Preventive Medicine 2001;32(2):182‐90.
Porter 1972 {published data only}
    1. Porter AM, McCullough DM. Counselling against cigarette smoking. A controlled study from a general practice. Practitioner 1972;209:686‐9. [MEDLINE: ]
Richmond 1986 {published data only}
    1. Richmond R, Webster I. Evaluation of general practitioner's use of a smoking intervention programme. International Journal of Epidemiology 1985;14:396‐401.
    1. Richmond RL, Austin A, Webster IW. Three year evaluation of a programme by general practitioners to help patients to stop smoking. British Medical Journal 1986;292:803‐6. [MEDLINE: ]
    1. Richmond RL, Webster IW. A smoking cessation programme for use in general practice. Medical Journal of Australia 1985;142:190‐4. [MEDLINE: ]
Rose 78‐92 {published and unpublished data}
    1. Rose G, Colwell L. Randomised controlled trial of anti‐smoking advice: final (20 year) results. Journal of Epidemiology and Community Health 1992;46:75‐7. [MEDLINE: ]
    1. Rose G, Hamilton PJS. A randomised controlled trial of the effect on middle‐aged men of advice to stop smoking. Journal of Epidemiology and Community Health 1978;32:275‐81.
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Russell 1979 {published data only}
    1. Russell MAH, Wilson C, Taylor C, Baker CD. Effect of general practitioners' advice against smoking. British Medical Journal 1979;2:231‐5. [MEDLINE: ]
Russell 1983 {published data only}
    1. Russell MAH, Merriman R, Stapleton J, Taylor W. Effect of nicotine chewing gum as an adjunct to general practitioner's advice against smoking. British Medical Journal 1983;287:1782‐5.
Schnoll 2003 {published data only}
    1. Schnoll RA, Zhang B, Rue M, Krook JE, Spears WT, Marcus AC, et al. Brief physician‐initiated quit‐smoking strategies for clinical oncology settings: a trial coordinated by the Eastern Cooperative Oncology Group. Journal of Clinical Oncology 2003;21(2):355‐65.
Segnan 1991 {published data only}
    1. Segnan N, Ponti A, Battista RN, Senore C, Rosso S, Shapiro SH, et al. A randomized trial of smoking cessation interventions in general practice in Italy. Cancer Causes and Control 1991;2:239‐46. [MEDLINE: ]
    1. Senore C, Battista RN, Ponti A, Segnan N, Shapiro SH, Rosso S, et al. Comparing participants and nonparticipants in a smoking cessation trial: Selection factors associated with general practitioner recruitment activity. Journal of Clinical Epidemiology 1999;52:83‐9.
    1. Senore C, Battista RN, Shapiro SH, Segnan N, Ponti A, Rosso S, et al. Predictors of smoking cessation following physicians' counseling. Preventive Medicine 1998;27(3):412‐21.
Severson 1997 {published data only}
    1. Severson HH, Andrews JA, Lichtenstein E, Wall M, Akers L. Reducing maternal smoking and relapse: Long‐term evaluation of a pediatric intervention. Preventive Medicine 1997;26:120‐30.
    1. Wall MA, Severson HH, Andrews JA, Lichtenstein E, Zoref L. Pediatric office‐based smoking intervention ‐ impact on maternal smoking and relapse. Pediatrics 1995;96:622‐8.
Slama 1990 {published data only}
    1. Slama K, Redman S, Perkins J, Reid AL, Sanson‐Fisher RW. The effectiveness of two smoking cessation programmes for use in general practice: a randomised clinical trial. BMJ 1990;300:1707‐9. [MEDLINE: ]
Slama 1995 {published data only}
    1. Slama K, Karsenty S, Hirsch A. Effectiveness of minimal intervention by general practitioners with their smoking patients: a randomised controlled trial in France. Tobacco Control 1995;4:162‐9.
Stewart 1982 {published data only}
    1. Stewart PJ, Rosser WW. The impact of routine advice on smoking cessation from family physicians. Canadian Medical Association Journal 1982;126:1051‐4. [MEDLINE: ]
Thompson 1988 {published data only}
    1. Thompson RS, Michnich ME, Friedlander L, Gilson B, Grothaus LC, Storer B. Effectiveness of smoking cessation interventions integrated into primary care practice. Medical Care 1988;26:62‐76. [MEDLINE: ]
Unrod 2007 {published data only}
    1. Unrod M, Smith M, Spring B, DePue J, Redd W, Winkel G. Randomized controlled trial of a computer‐based, tailored intervention to increase smoking cessation counseling by primary care physicians. Journal of General Internal Medicine 2007;22:478‐84.
Vetter 1990 {published data only}
    1. Vetter NJ, Ford D. Smoking prevention among people aged 60 and over: a randomized controlled trial. Age and Ageing 1990;19:164‐8. [MEDLINE: ]
Williams 2002 {published data only}
    1. Williams GC, Deci EL. Activating patients for smoking cessation through physician autonomy support. Medical Care 2001;39:813‐23.
    1. Williams GC, Gagne M, Ryan RM, Deci EL. Facilitating autonomous motivation for smoking cessation. Health Psychology 2002;21(1):40‐50.
Wilson 1982 {published data only}
    1. Kozlowski LT, Page A. A second look at the effects of supportive follow‐up on smoking cessation. Canadian Medical Association Journal 1987;137:605‐7.
    1. Wilson D, Wood G, Johnston N, Sicurella J. Randomized clinical trial of supportive follow‐up for cigarette smokers in a family practice. Canadian Medical Association Journal 1982;126:127‐9. [MEDLINE: ]
Wilson 1990 {published data only}
    1. Wilson DH, Wakefield MA, Steven ID, Rohrsheim RA, Esterman AJ, Graham NM. "Sick of Smoking": evaluation of a targeted minimal smoking cessation intervention in general practice. Medical Journal of Australia 1990;152:518‐21. [MEDLINE: ]
References to studies excluded from this review Ahluwalia 1999 {published data only}
    1. Ahluwalia LS, Gibson CA, Kenney RE, Wallace DD, Resnicow K. Smoking status as a vital sign. Journal of General Internal Medicine 1999;14:402‐8.
Aleixandre 1998 {published data only}
    1. Aleixandre i Marti E, Casanova Matutano MA, Mitjans Lafont J, Sanchez Monfort J, Sanmartin Almenar A. [Clinical trial of 2 tobacco use cessation interventions in primary care] [Spanish]. Atencion Primaria 1998;22(7):424‐8.
Andrews 2006 {published data only}
    1. Andrews K, Bale P, Chu J, Cramer A, Aveyard P. A randomized controlled trial to assess the effectiveness of a letter from a consultant in causing smokers to stop smoking pre‐operatively. Public Health 2006;120(4):356‐8.
Angeles‐Silva 2005 {published data only}
    1. Angeles‐Silva E, Castañeda E, Catari A, Daza G, Florez A, Morales A. Efficacy of brief intervention for tobacco smoking cessation [Eficacia de la intervención breve para la cesación del consumo de tabaco]. Medicina Interna (Caracas) 2005;21(1):33‐40.
Audrain‐McGovern 2011 {published data only}
    1. Audrain‐McGovern J, Stevens S, Murray PJ, Kinsman S, Zuckoff A, Pletcher J, et al. The efficacy of motivational interviewing versus brief advice for adolescent smoking behavior change. Pediatrics 2011;128(1):101‐11.
Bakkevig 2000 {published data only}
    1. Bakkevig O, Steine S, Hafenbradl K, Laerum E. Smoking cessation ‐ A comparative, randomised study between management in general practice and the behavioural programme SmokEnders. Scandinavian Journal of Primary Health Care 2000;18(4):247‐51.
Becker 2005 {published data only}
    1. Becker DM, Yanek LR, Johnson WR Jr, Garrett D, Moy TF, Reynolds SS, et al. Impact of a community‐based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease. Circulation 2005;111(10):1298‐304.
Bentz 2007 {published data only}
    1. Bentz CJ, Bayley KB, Bonin KE, Fleming L, Hollis JF, Hunt JS, et al. Provider feedback to improve 5A's tobacco cessation in primary care: a cluster randomized clinical trial. Nicotine and Tobacco Research 2007;9:341‐9.
Borland 2008 {published data only}
    1. Borland R, Balmford J, Bishop N, Segan C, Piterman L, McKay‐Brown L, et al. In‐practice management versus quitline referral for enhancing smoking cessation in general practice: A cluster randomized trial. Family Practice 2008;25(5):382‐9.
BTS 1983 {published data only}
    1. Research Committee of the British Thoracic Society. Comparison of four methods of smoking withdrawal in patients with smoking related diseases. Report by a subcommittee of the Research Committee of the British Thoracic Society. British Medical Journal 1983;286:595‐7. [MEDLINE: ]
Buffels 2006 {published data only}
    1. Buffels J, Degryse J, Decramer M, Heyrman J. Spirometry and smoking cessation advice in general practice: A randomised clinical trial. Respiratory Medicine 2006;100(11):2012‐7.
Cabezas 2009 {published data only}
    1. Cabezas C, Martin C, Granollers S, Morera C, Ballve JL, Zarza E, et al. Effectiveness of a stepped primary care smoking cessation intervention (ISTAPS study): design of a cluster randomised trial. BMC Public Health 2009;106(9):1696‐706.
    1. Cabezas C, Martin C, Granollers S, Morera C, Ballve JL, Zarza E, et al. Effectiveness of a stepped primary care smoking cessation intervention: cluster randomized clinical trial (ISTAPS study). BMC Public Health 2009;9:48.
Carpenter 2004 {published data only}
    1. Carpenter MJ, Hughes JR, Solomon LJ, Callas PW. Both smoking reduction with nicotine replacement therapy and motivational advice increase future cessation among smokers unmotivated to quit. Journal of Consulting and Clinical Psychology 2004;72(3):371‐81.
Chahal 2005 {published data only}
    1. Chahal AS, Kishan J, Dhillon A. A comparative study of the role of physician advice and nicotine replacement therapy in smoking cessation. Chest 2005;128(4):386S.
Cohen 1989a {published data only}
    1. Cohen SJ, Stooky GK, Katz BP, Drook CA, Smith DM. Encouraging primary care physicians to help smokers quit. A randomized, controlled trial. Annals of Internal Medicine 1989;110:648‐52.
Cohen 1989b {published data only}
    1. Cohen SJ, Stookey GK, Katz BP, Drook CA, Christen AG. Helping smokers quit: a randomized controlled trial with private practice dentists. Journal of the American Dental Association 1989;118:41‐5.
Colby 2005 {published data only}
    1. Colby SM, Monti PM, O'Leary‐Tevyaw T, Barnett NP, Spirito A, Rohsenow DJ. Brief motivational intervention for adolescent smokers in medical settings. Addictive Behaviors 2005;30:865‐74.
Conger 1987 {published data only}
    1. Conger B, Nelson EC, Dietrich AJ, Blanchard C, McHugo GJ, Simmons JJ, et al. Effectiveness of physician antismoking advice. American Journal of Preventive Medicine 1987;3:223‐6. [MEDLINE: ]
Cummings 1989a {published data only}
    1. Cummings SR, Richard RJ, Duncan CL, Hansen B, Vander Martin R, Gerbert B, et al. Training physicians about smoking cessation: a controlled trial in private practice. Journal of General Internal Medicine 1989;4:482‐9. [MEDLINE: ]
Cummings 1989b {published data only}
    1. Cummings SR, Coates TJ, Richard RJ, Hansen B, Zahnd EG, Vander Martin R, et al. Training physicians in counseling about smoking cessation. A randomized trial of the "Quit for Life" program. Annals of Internal Medicine 1989;110:640‐7. [MEDLINE: ]
Etter 2006 {published data only}
    1. Etter JF. Impact of educational outreach visits on smoking cessation activities perfomed by specialist physicians: a randomized trial. Education for Health 2006;19:155‐65.
Fang 2006 {published data only}
    1. Fang CY, Ma GX, Miller SM, Tan Y, Su X, Shive S. A brief smoking cessation intervention for Chinese and Korean American smokers. Preventive Medicine 2006;43(4):321‐4.
Folsom 1987 {published data only}
    1. Folsom AR, Grimm RH. Stop smoking advice by physicians: a feasible approach?. American Journal of Public Health 1987;77:849‐50. [MEDLINE: ]
Graham 2011 {published data only}
    1. Graham AL, Cobb NK. A randomized trial of internet and telephone treatment for smoking cessation. Archives of Internal Medicine 2011;171(5):46‐53.
Grandes 2000 {published data only}
    1. Grandes G, Cortada JM, Arrazola A. An evidence‐based programme for smoking cessation: effectiveness in routine general practice. British Journal of General Practice 2000;50(459):803‐7.
    1. Grandes G, Cortada JM, Arrazola A, Laka JP. Predictors of long‐term outcome of a smoking cessation programme in primary care. British Journal of General Practice 2003;53(487):101‐7.
Grogan 2011 {published data only}
    1. Grogan S, Flett K, Clark‐Carter D, Conner M, Davey R, Richardson D, et al. A randomized controlled trial of an appearance‐related smoking intervention. Health Psychology 2011;30(6):805‐9. [PUBMED: 21767016]
Haug 2010 {published data only}
    1. Haug S, Meyer C, Ulbricht S, Gross B, Rumpf HJ, John U. Need for cognition as a predictor and a moderator of outcome in a tailored letters smoking cessation intervention. Health Psychology 2010;29(4):367‐73. [PUBMED: 20658823]
Haug 2012 {published data only}
    1. Haug S, Meyer C, Dymalski A, Lippke S, John U. Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults: study protocol of a cluster randomised controlled trial. BMC Public Health 2012;12:51. [PUBMED: 22260736]
Hjalmarson 2007 {published data only}
    1. Hjalmarson A, Boëthius G. The effectiveness of brief advice and extended smoking cessation counseling programs when implemented routinely in hospitals.. Preventive Medicine 2007;45:202‐7.
Hollis 1993 {published data only}
    1. Hollis JF, Lichtenstein E, Vogt TM, Stevens VJ, Biglan A. Nurse‐assisted counseling for smokers in primary care. Annals of Internal Medicine 1993;118:521‐5. [MEDLINE: ]
Hurt 1994 {published data only}
    1. Hurt RD, Dale LC, Fredrickson PA, Caldwell CC, Lee GA, Offord KP, et al. Nicotine patch therapy for smoking cessation combined with physician advice and nurse follow‐up: One‐year outcome and percentage of nicotine replacement. JAMA 1994;271:595‐600. [MEDLINE: ]
Hymowitz 2006 {published data only}
    1. Hymowitz N, Schwab J, Haddock CK, Pyle S, Meshberg S. The Pediatric Resident Training on Tobacco Project: Interim findings. Journal of the National Medical Association 2006;98:190‐203.
    1. Hymowitz N, Schwab J, Keith‐Haddock C, Pyle S, Meshberg S. The pediatric residency training on tobacco project: baseline findings from the patient tobacco survey. Preventive Medicine 2005;41:159‐66.
Jackson 2004 {published data only}
    1. Jackson AA, Manan WA, Gani AS, Eldridge S, Carter YH. Beliefs and behavior of deceivers in a randomized, controlled trial of anti‐smoking advice at a primary care clinic in Kelantan, Malaysia. The Southeast Asian Journal of Tropical Medicine and Public Health 2004;35(3):748‐55.
Juarranz Sanz 1998 {published data only}
    1. Juarranz Sanz M, Soriano Llora T, Reyes Martin G, Sanchez Sachez MI. Efficacy of treatment with nicotine replacement in smoking cessation through Primary Health Care [Spanish]. Revista de Medicina Familiar y Comunitaria 1998;8(6):376‐83.
Kadowaki 2000 {published data only}
    1. Kadowaki T, Watanabe M, Okayama A, Hishida K, Ueshima H. Effectiveness of smoking‐cessation intervention in all of the smokers at a worksite in Japan. Industrial Health 2000;38(4):396‐403.
Kalkhuis‐Beam 2011 {published data only}
    1. Kalkhuis‐Beam S, Stevens SL, Baumritter A, Carlson EC, Pletcher JR, Rodriguez D, et al. Participant‐ and study‐related characteristics predicting treatment completion and study retention in an adolescent smoking cessation trial. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2011;49(4):371‐8. [PUBMED: 21939867]
Knight 1989 {published data only}
    1. Knight RA, Hay DA. The relevance of the health belief model to Australian smokers. Social Science & Medicine 1989;28(12):1311‐4.
Kottke 1989 {published data only}
    1. Kottke TE, Brekke ML, Solberg LI, Hughes JR. A randomized trial to increase smoking intervention by physicians. Doctors Helping Smokers, Round I. JAMA 1989;261:2101‐6. [MEDLINE: ]
Kozlowski 1987 {published data only}
    1. Kozlowski LT, Page A. A second look at the effects of supportive follow‐up on smoking cessation. Canadian Medical Association Journal 1987;137:605‐7. [MEDLINE: ]
Kreuter 2000 {published data only}
    1. Kreuter MW, Chheda SG, Bull FC. How does physician advice influence patient behavior? Evidence for a priming effect. Archives of Family Medicine 2000;9:426‐33.
Loeb 1983 {unpublished data only}
    1. Loeb BK, Waage G, Bailey J. Smoking intervention in pregnancy. Proceedings on the 5th World Conference on Smoking and Health. Ottawa: Canadian Council on Smoking and Health, 1983:389‐95.
Loke 2005 {published data only}
    1. Loke AY, Lam TH. A randomized controlled trial of the simple advice given by obstetricians in Guangzhou, China, to non‐smoking pregnant women to help their husbands quit smoking. Patient Education and Counseling 2005;59:31‐7.
Lopez 2007 {published data only}
    1. Lopez ML, Iglesias JM, Valle MO, Comas A, Fernandez JM, Vries H, et al. Impact of a primary care intervention on smoking, drinking, diet, weight, sun exposure, and work risk in families with cancer experience. Cancer Causes & Control 2007;18(5):525‐35.
Macarthur 1987 {published data only}
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Manfredi 1999 {published data only}
    1. Manfredi C, Crittenden KS, Cho YI, Gao S. Long‐term effects (up to 18 months) of a smoking cessation program among women smokers in public health clinics. Preventive Medicine 2004;38:10‐19.
    1. Manfredi C, Crittenden KS, Warnecke R, Engler J, Cho YI, Shaligram C. Evaluation of a motivational smoking cessation intervention for women in public health clinics. Preventive Medicine 1999;28:51‐60.
Mayer 1990 {published data only}
    1. Mayer JP, Hawkins B, Todd R. A randomized evaluation of smoking cessation interventions for pregnant women at a WIC clinic. American Journal of Public Health 1990;80(1):76‐8. [MEDLINE: ]
McAfee 2005 {published data only}
    1. McAfee T, Ludman E, Grothaus L, Zbikowski SM, Bush T, Hollis J, et al. Physician tobacco advice to preteens in a smoking‐prevention randomized trial: steering clear. Journal of Pediatric Psychology 2005;30:371‐6.
McEwen 2002 {published data only}
    1. McEwen A, Preston A, West R. Effect of a GP desktop resource on smoking cessation activities of general practitioners. Addiction 2002;97(5):595‐7.
McEwen 2006 {published data only}
    1. McEwen A, West R, Preston A. Triggering anti‐smoking advice by GPs: mode of action of an intervention stimulating smoking cessation advice by GPs. Patient Education & Counseling 2006;62:89‐94.
Messimer 1989 {published data only}
    1. Messimer SR, Hickner JM, Henry RC. A comparison of two antismoking interventions among pregnant women in eleven private primary care practices. Journal of Family Practice 1989;28:283‐8. [MEDLINE: ]
Miller 1997 {published data only}
    1. Miller NH, Smith PM, DeBusk RF, Sobel DS, Taylor CB. Smoking cessation in hospitalized patients. Results of a randomized trial. Archives of internal medicine 1997;157(4):409‐15. [PUBMED: 9046892]
Murray 2008 {published data only}
    1. Murray RL, Coleman T, Antoniak M, Fergus A, Britton J, Lewis SA. The potential to improve ascertainment and intervention to reduce smoking in primary care: a cross sectional survey. Bmc Health Services Research 2008;8:6.
    1. Murray RL, Coleman T, Antoniak M, Stocks J, Fergus A, Britton J, et al. The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: A cluster‐randomized trial. Addiction 2008;103(6):998‐1006.
Ramos 2010 {published data only}
    1. Ramos M, Ripoll J, Estrades T, Socias I, Fe A, Duro R, et al. Effectiveness of intensive group and individual interventions for smoking cessation in primary health care settings: a randomized trial. BMC public health 2010;10:89. [PUBMED: 20178617]
Regan 2011 {published data only}
    1. Regan S, Reyen M, Lockhart AC, Richards AE, Rigotti NA. An interactive voice response system to continue a hospital‐based smoking cessation intervention after discharge. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 2011;13(4):255‐60. [PUBMED: 21330278]
Richman 2000 {published data only}
    1. Richman PB, Dinowitz S, Nashed AH, Eskin B, Sylvan E, Allegra C, et al. The emergency department as a potential site for smoking cessation intervention: A randomized, controlled trial. Academic Emergency Medicine 2000;7(4):348‐53.
Risser 1990 {published data only}
    1. Risser NL, Belcher DW. Adding spirometry, carbon monoxide, and pulmonary symptom results to smoking cessation counseling: a randomized trial. Journal of General Internal Medicine 1990;5:16‐22. [MEDLINE: ]
Rodriguez 2003 {published data only}
    1. Guallar‐Castillon P, Lafuente‐Urdinguio P, Garteizaurrekoa‐Dublang P, Sainz‐Martinez O, Diez‐Azcarate JI, Foj‐Aleman M, et al. [Probability of success in tobacco quitting during the course of two simple medical interventions] [Spanish] [Probabilidad de exito en el abandono del tabaco en el curso de dos intervenciones sencillas para dejar de fumar]. Revista Espanola de Salud Publica 2003;77(1):117‐24.
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Rodriguez‐Alvarez 2011 {published data only}
    1. Rodriguez‐Alvarez M, Toran‐Monserrat P, Munoz‐Ortiz L, Negrete‐Palma A, Montero‐Alia JJ, Jimenez‐Gonzalez M, et al. Effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers: a randomized controlled trial. ESPIROTAB study. BMC Fam.Pract. 2011;12:61.
Russell 1987 {published data only}
    1. Russell MA, Stapleton JA, Hajek P, Jackson PH, Belcher M. District programme to reduce smoking: can sustained intervention by general practitioners affect prevalence?. Journal of Epidemiology and Community Health 1988;42:111‐5. [MEDLINE: ]
    1. Russell MAH, Stapleton JA, Jackson PH, Hajek P, Belcher M. District programme to reduce smoking: effect of clinic supported brief intervention by general practitioners. British Medical Journal 1987;295:1240‐4. [MEDLINE: ]
Sanchez Beiza 1992 {published data only}
    1. Sanchez Beiza L, Martin Carrillo Dominguez P, Gil Serrano P, Gomez Gil E, Pascual de la Torre M, Valero Martinez A. [Preliminary study of smoking cessation at 6 months following medical counseling, pamphlet, and follow‐up] [Spanish] [Estudio preliminar del abandono del tabaco a los 6 meses tras consejo medico, folleto y seguimento]. Atencio Primaria 1992;10:738‐41. [MEDLINE: ]
Sanz‐Pozo 2006 {published data only}
    1. Sanz‐Pozo B, Miguel‐Diez J, Anegon‐Blanco M, Garcia‐Carballo M, Gomez‐Suarez E, Fernandez‐Dominguez JF. [Effectiveness of a programme of intensive tobacco counselling by nursing professionals] [Spanish] [Efectividad de un programa de consejo antitabaco intensivo realizado por profesionales de enfermeria]. Atencion Primaria 2006;37:266‐72.
Secades‐Villa 2009 {published data only}
    1. Secades‐Villa R, Alonso‐Perez F, Garcia‐Rodriguez O, Fernandez‐Hermida JR. Effectiveness of three intensities of smoking cessation treatment in primary care. Psychological reports 2009;105(3 Pt 1):747‐58.
Secker‐Walker 1998 {published data only}
    1. Secker‐Walker RH, Solomon LJ, Flynn BS, Skelly JM, Mead PB. Smoking relapse prevention during pregnancy. A trial of coordinated advice from physicians and individual counseling. American Journal of Preventive Medicine 1998;15:25‐31.
Sippel 1999 {published data only}
    1. Sippel JM, Osborne ML, Bjornson W, Goldberg B, Buist AS. Smoking cessation in primary care clinics. Journal of General Internal Medicine 1999;14:670‐6. [MEDLINE: ]
Smith 2009 {published data only}
    1. Smith PM, Burgess E. Smoking cessation initiated during hospital stay for patients with coronary artery disease: a randomized controlled trial. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 2009;180(13):1297‐303. [PUBMED: 19546455]
Soria 2006 {published data only}
    1. Aveyard P. Motivational interviewing for smokers. British Journal of General Practice 2007;57:67.
    1. Soria R, Legido A, Escolano C, Yeste AL, Montoya J. A randomised controlled trial of motivational interviewing for smoking cessation. British Journal of General Practice 2006;56:768‐74.
Stratelis 2006 {published data only}
    1. Stratelis G, Molstad S, Jakobsson P, Zetterstrom O. The impact of repeated spirometry and smoking cessation advice on smokers with mild COPD. Scandinavian Journal of Primary Health Care 2006;24:133‐9.
Strecher 1991 {published data only}
    1. Strecher VJ, O'Malley MS, Villagra VG. Can residents be trained to counsel patients about quitting smoking? Results from a randomized trial. Journal of General Internal Medicine 1991;6:9‐17. [MEDLINE: ]
Tait 2007 {published data only}
    1. Tait RJ, Hulse GK, Waterreus A, Flicker L, Lautenschlager NT, Jamrozik K, et al. Effectiveness of a smoking cessation intervention in older adults. Addiction 2007;102:148‐55.
Takahashi 2006 {published data only}
    1. Takahashi K, Saso H, Saka H, Saso H, Iwata M, Hashimoto I, et al. A pilot study on inducement of smoking cessation by a simple 5A (asking, advice, assess, assist, and arrange) approach at outpatient clinics. Asian Pacific Journal of Cancer Prevention 2006;7:131‐5.
Torrecilla 2001 {published data only}
    1. Torrecilla‐Garcia M, Barrueco‐Ferrero M, Maderuelo‐Fernandez J, Jimenez‐Ruiz C, Plaza‐Martin M, Hernandez‐Mezquita M. Tobacco detoxication at a primary care clinic: efficacy of medical counseling, minimal intervention and nicotine replacement therapy at the one‐year follow‐up. Atencion Primaria 2001;27(9):629‐36.
Twardella 2007 {published data only}
    1. Breitling LP, Twardella D, Hoffmann MM, Witt SH, Treutlein J, Brenner H. Prospective association of dopamine‐related polymorphisms with smoking cessation in general care. Pharmacogenomics 2010;11(4):527‐36.
    1. Salize HJ, Merkel S, Reinhard I, Twardella D, Mann K, Brenner H. Cost‐effective primary care‐based strategies to improve smoking cessation: more value for money. Archives of Internal Medicine 2009;169(3):230‐5.
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    1. Twardella D, Brenner H. Strategies to promote smoking cessation in general practice: Results of a cluster‐randomized trial. American Journal of Epidemiology 2005;161(11):S105.
Van 2006 {published data only}
    1. Weel C, Bakx C, HH, Thien T, BW. Long‐term outcome of cardiovascular prevention: A Nijmegen Academic Family Practices Network study. Journal of the American Board of Family Medicine 2006;19(1):62‐8.
Ward 2006 {published data only}
    1. Ward KD, Asfar T, Vander Weg MW, Hammal F, Eissenberg T, Maziak W. Outcomes from Syria's first smoking cessation trial (POS1‐74). Society for Research on Nicotine and Tobacco 12th Annual Meeting February 15‐18, Orlando, Florida. 2006.
Williams 2006 {published data only}
    1. Williams GC, McGregor H, Sharp D, Kouides RW, Levesque CS, Ryan RM, et al. A self‐determination multiple risk intervention trial to improve smokers' health. Journal of General Internal Medicine 2006;21(12):1288‐94.
Wilson 1988 {published data only}
    1. Wilson DM, Taylor DW, Gilbert JR. A randomised trial of a family physician intervention for smoking cessation. JAMA 1988;260:1570‐4. [MEDLINE: ]
Windsor 1985 {published data only}
    1. Windsor RA, Cutter G, Morris J, Reese Y, Manzella B, Bartlett EE, et al. The effectiveness of smoking cessation methods for smokers in public health maternity clinics: a randomized trial. American Journal of Public Health 1985;75:1389‐92. [MEDLINE: ]
Young 2002 {published data only}
    1. Young JM, D'Este C, Ward JE. Improving family physicians use of evidence‐based smoking cessation strategies: a cluster randomization trial. Preventive Medicine 2002;35(6):572‐83.
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References to ongoing studies Martin‐Lujan 2011 {published data only}
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Additional references Bize 2012
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Cahill 2010
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Cahill 2012
    1. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 4. [DOI: 10.1002/14651858.CD006103.pub6]
Carson 2012
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Chapman 1993
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Cochrane Handbook
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Coleman 2000
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Denny 2003
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Dickinson 1989
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Fiore 1996
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Fiore 2008
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Higgins 2003
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Hughes 2007
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Kottke 1988
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Lai 2010
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Lancaster 2005a
    1. Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. [DOI: 10.1002/14651858.CD001292.pub2]
Lancaster 2005b
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Lumley 2009
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McEwen 2001
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McLeod 2000
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Miller 2001
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NHC 2002
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Raw 1998
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Rollnick 1997
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Solberg 2001
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Stead 2005
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Stead 2006
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Stead 2012
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West 2000
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West 2005
    1. West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction 2005;100:299‐303.
References to other published versions of this review Lancaster 2004
    1. Lancaster T, Stead LF. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2004, Issue 4. [DOI: 10.1002/14651858.CD000165.pub2]
Silagy 1996
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Silagy 1997
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Silagy 1999
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Silagy 2001
    1. Silagy C, Stead L. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD000165]
Stead 2008a
    1. Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2008, Issue 2. [DOI: 10.1002/14651858.CD000165.pub3]

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