BMJ  2003;326:1175-1177 (31 May), doi:10.1136/bmj.326.7400.1175

Primary Care

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

Robert Paul Riemsma, senior research fellow1, Jill Pattenden, research fellow2, Christopher Bridle, senior lecturer in health psychology3, Amanda J Sowden, associate director1, Lisa Mather, information officer1, Ian S Watt, professor of primary care2, Anne Walker, senior behavioural scientist4

1 Centre for Reviews and Dissemination, University of York, York YO10 5DD, 2 Department of Health Sciences, University of York, 3 School of Counselling and Health Psychology, University of the West of England, Bristol BS16 2JP, 4 Health Services Research Unit, University of Aberdeen, Forester Hill, Aberdeen AB25 2ZD

Correspondence to: R P Riemsma rpr1{at}york.ac.uk

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.


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Evidence on stage based approach to smoking cessation is limited
BMJ 2003 326: 0. [Full Text]

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