What evidence suggests that behavioral and pharmacological interventions for tobacco dependence are effective?
A meta-analysis of smoking cessation interventions in hospitalized patients identified that intensive counseling interventions initiated in hospital with supportive contacts for at least 1 month after discharge increase smoking cessation rates compared with usual care (RR, 1.37 95% CI, 1.27 1.48), with comparable findings in patients with CVD (RR, 1.42 95% CI, 1.29 1.56) and interventions initiated in rehabilitation settings. Furthermore, the addition of nicotine replacement therapy to the intervention increased cessation rates compared with intensive counseling alone (RR, 1.54 95% CI, 1.43 1.66). High-quality evidence also supports combined pharmacotherapy (nicotine replacement therapy, varenicline, or bupropion) and behavioral interventions compared with usual care, brief advice, or less intensive counseling in smoking cessation (RR, 1.83 95% CI, 1.68 1.98) in health care and community settings. Group behavior therapy programs for smoking cessation are also superior to self-help programs but are not superior to individual counseling of similar intensity.