Table 4.
Included Articles (Alphabetical Order) With A Multiple Session Intervention
| Reference Study Type |
Context | Strategy | Outcomes |
|---|---|---|---|
| Barbarin O.A. 197861 RCT |
USA. Primary care. 60 adults smoking more than 1 pack/day | Self-control strategies focusing on negative consequences and side effects of smoking. Ten, 1 hr, group sessions over 1 month. Overt aversion (O), forced smoking to experience side effects, symbolic aversion (S), imagining negative consequences of smoking, or combined (Cb). | Point prevalence abstinence (per protocol) 3 mo: 72% (O) vs 41% (S) vs 47 (Cb) vs 8% (c) 12 mo: 44% (O) vs 16% (S) vs 25% (Cb) vs 0% (c) |
| Canga et al 200062 RCT |
Spain. Primary care, Nurse. 280 diabetic smokers. | An initial 40-min visit adapted to the patient’s smoking history. Follow-up by phone calls or visits: 5 contacts over 6 months. By a trained nurse, based on motivational interviewing and the transtheoretical (Prochaska) model. NRT when indicated. | Point prevalence abstinence 6 mo: 17% vs 2.3% (c) |
| Cinciripini et al.199463 Non-randomized controlled trial |
USA. Primary care, General population. 34 smokers. |
Eight 90 mins weekly motivational interviewing and cognitive-behavioral sessions and a relapse prevention program. Scheduled progressive reduction of the number of cigarettes over 5 weeks with a set date for quitting. | Point prevalence abstinence 6 mo: 53% vs 6% (c) 12 mo: 41% vs 6% (c) |
| Cinciripini et al.199564 RCT |
USA. Primary care, general population. 128 smokers |
Scheduled gradual reduction with a quit date set at week 5. Nine weekly meetings based on motivational interviewing. | Point prevalence abstinence 6 mo: 41% vs 13% (c) 12 mo: 44% vs 22%(c) |
| Hilberink et al 200565 RCT |
Netherlands. Primary care. 392 COPD patients. |
GPs individual motivational interviewing using the transtheoretical model. 5 consultations and 3 follow-up phone calls by the practice nurse. Information about NRT. Education booklet and videotape were provided. | Point prevalence abstinence 6 mo: 16% vs 8.8% (c) |
| Hollis et al 199145 RCT |
Netherlands. Primary care. 3161 smokers. | A professional group program: intensive nine group meetings over 2 months. | Point prevalence abstinence 3 mo: 14.1% vs 7% (c) Continuous abstinence 3 mo: 12% vs 6% (c) |
| Hollis et al 200766 RCT |
USA. Community, Telephone Quit-line. 4600 smokers, planning to quit. | Initial 40‐min session of phone counseling followed by two interventions. The moderate intervention (M): 1 follow-up call. Or the intensive intervention (I) by experienced tobacco counsellors (more effective): 4 additional phone calls over 3 months and personalized self-help material. Based on motivational interviewing techniques and transtheoretical model. | Continuous abstinence with NRT 6 mo: 24.3% (I) vs 21.3% (M) vs 16.8% (c) 12 mo: 21.2% (I) vs 20.1% (M) vs 17% (c) no NRT 6 mo: 13.1% (I) vs 10.7% (M) vs 10.2% (c) 12 mo: 17.1% (I) vs 13.8% (M) vs 11.7% (c) |
| Marcus et al 199967 RCT |
USA. General population. 281 sedentary female smokers aged 18 to 65. |
12 weekly sessions of a cognitive-behavioral program (self-monitoring, stimulus control, coping with cravings) associated with vigorous exercise (3 sessions per week) to reduce weight gain after smoking cessation. Provided by therapists and exercise specialists. | Continuous abstinence 3 mo: 16.4% vs 8.2% (c) 12 mo: 11.9% vs 5.4% (c) |
| Marks et al 200268 RCT |
UK, economically deprived area of north London. 260 smokers. |
Program using a spectrum of 30 cognitive- behavioral techniques and self-help material (written, audio). Initial 60-min session with therapists (3 to 12 people), one follow-up session and a phone call at 3 months. | Point prevalence abstinence 12 mo: 19.8% vs 5.8% (c) |
| Meyer et al 198069 Non randomized controlled trial |
USA. High CVD risk smokers in 3 towns with 500 people recruited in each town, aged 35 to 59. | Intervention on multiple risk behaviors: dietary, smoking and exercise behavior. Mass media campaign: radio and television, weekly newspaper columns, posters, and printed material sent by mail. Followed by 9 face-to-face counseling sessions (1 to 3.5 hrs) over 3 months for the subject and spouse. Led by a group leader and trained counselors. Based on the social learning theory and behavioral self-control principles. | Point prevalence abstinence 12 mo: 32.5% vs 6.4% (c) 24 mo: 47.1% vs 10.6% (c) 36 mo: 50% vs 14.9% (c) |
| Neaton et al 198170 RCT |
USA. Community recruitment. 12,866 CVD high-risk middle-aged men. |
10 weekly group meetings of 1 to 2 hrs led by counselors, combining nutrition, smoking and hypertension programs. Using social support (family) and skills development. Followed by the extended intervention which was individualized, based on results at 4 months. | Point prevalence abstinence 12 mo: 28% vs 8% (c) 24 mo: 28% vs 11% (c) 36 mo: 28.7% vs 13% (c) 48 mo: 29.9% vs 15.3% (c) |
| Nohlert et al 200971 RCT |
Sweden. General population. 300 smokers attending dental or primary care. | Eight 40-min individual sessions by a trained dental hygienist over a 4-month period. Based on a mixture of behavior therapy, coaching and pharmacological advices. |
Continuous abstinence 12 mo: 18% vs 9% (c) |
| Perkins et al 200172 RCT |
USA. 219 women smokers concerned about weight gain after smoking cessation. | Cognitive-behavioral therapy by a woman therapist: acceptance of modest weight gain, benefits of quitting superseding the health risks of weight gain. 90-min sessions, twice per week for 3 weeks then weekly sessions for 4 weeks. | Continuous abstinence 6 mo: 28% vs 12% (c) 12 mo: 21% vs 12% (c) |
| Soria et al 200673 RCT |
Spain. Primary care, general population. 200 smokers. |
Three individual 20-min sessions by a GP, based on motivational interviewing and the transtheoretical model. NRT when appropriate. | Point prevalence abstinence 6 and 12 mo: 18.4% vs 3.5% (c) |
| Steptoe et al 199974 Cluster RCT |
UK. Primary care. 883 people with one or more modifiable risk factors | Two to three counseling sessions with a practice nurse trained in behavioral change techniques followed by two phone calls. Based on the transtheoretical model. NRT when appropriate. | Cigarettes/day 3 mo: 7.1% vs 18 (c) 12 mo: 8.0% vs 2.7 (c) Continuous abstinence: NS |
| Wood et al 199475 RCT |
UK. Primary care, Nurses. Family recruitment: 12,472 men and their partners. | Family-centered nurse led counseling. Subjects were told their CVD risk in relative to other people of the same age. The frequency of follow-up visits was determined by both the CVD risk score and individual risk factors: the higher the risk score, the more frequent the visits. | Smoking prevalence 12 mo: Men 19% vs 23% (c) Women 17.7% vs 21.5% (c) |
| Wu et al 200976 RCT |
USA, Chinese community in New York. 122 smokers | Four 60-min individual sessions, in Chinese and based on motivational interviewing. Self-help materials. Phone calls follow-up. NRT provided if indicated. | Point prevalence abstinence 3 mo: 66.1% vs 32% (c) 6 mo: 66.7% vs 31.7% (c) |
| Cornuz et al 200277 Cluster RCT |
Switzerland. 35 residents in general practice. 251 smokers. | Training program for residents in general practice focusing on the medical issues of smoking. Based on the transtheoretical model. | Point prevalence abstinence 12 mo: 13% vs 5% (c) |
Abbreviations: RCT, randomized controlled trial; NRT, nicotine replacement therapy; GP, general practitioner; mo, months; vs, versus; (c), control group; NS, no significant difference.