Smoking cessation treatments increase quit rates in older adults

Chen, D and Wu, L. Smoking cessation interventions for adults aged 50 or older: A systematic review and meta-analysis Drug Alcohol Depend. 2015;154:14-24.

Review question

Do smoking cessation treatments help adults 50 and older quit smoking?  Which treatments are the most effective?

Background

Quitting smoking can increase life expectancy and reduce health risks. Smokers over 65 years old are less interested and less likely to quit smoking compared to younger smokers. However, when treatments focus on older adults, older adults achieve quit rates similar to younger smokers.

How the review was done

This is a meta-analysis of 21 randomized controlled trials focused on smoking cessation treatment among adult smokers over age 50.

Key features of the studies:

• Three types of treatment were assessed: 2 studies used pharmacotherapy (nicotine patches/gums, bupropion medication), 16 studies used non-pharmacological treatment (physician/nurse counseling, group counseling, education, quit helpline) and 8 used a combined approach (medication and non-pharmacological treatments)
• The number of participants in each study ranged from 18 to 7354 people
• On average, participants had been smokers for 39 years
• Studies measured the number and percentage of people who quit after treatment
• Results were compared to people who did not receive smoking cessation treatment

What the researchers found

People who received any smoking cessation treatment were more likely to successfully quit compared to those who did not receive treatment in most studies. A combined approach (medication as well as non-pharmacological treatments) was the most effective. Average quit rates were 26% for pharmacotherapy, 28% for non-pharmacological treatment and 37% for a combined approach. Only 19% of participants who did not receive smoking cessation treatment quit smoking. Treatments that were delivered face-to-face rather than over the phone were more effective.

More research is needed to measure success of these treatments in diverse populations like minority groups. Non-pharmacological treatments were very different in their various approaches which made it difficult to compare findings. More consistent approaches would be easier to study and determine the best alternatives to pharmacological treatments.  

Conclusion

Pharmacotherapy and non-pharmacological smoking cessation treatments help people quit smoking. A combined approach is the most effective way to improve smoking quit rates in adults over 50 years old.