Smoking: individual counseling increases quit rates

Clinical bottom line (level 2a)

  1. Smokers who receive individual counseling compared with minimal support are more likely to stop smoking (NNT = 21 at 6 months) .
  2. Individual counseling is not clearly more effective than brief advice or group sessions.
Lancaster and Stead: Cochrane Library 1999; 2 : -
Expires May 2004

The study

Systematic review of all randomised or quasi-randomised trials of
  • Patients: smokers wanting to quit
  • Intervention: face-to-face individual counselling compared with minimal intervention, brief counselling or group therapy
  • Outcome: smoking cessation at 6 months

Articles found in ?all languages using Cochrane Tobacco Addiction Group trials register (including Medline, PsycLit, Embase, (search terms: detailed in text )

Selection criteria: by 2 independent reviewers: see above and below
Appraisal criteria: by 2 independent reviewers: using method of randomisation, completeness of follow-up
Articles excluded if:
  • follow-up < 6 months
  • pregnant women
  • advice provided by doctors or nurses
11 studies found - 10 compared individual counselling to minimal intervention, 2 compared two intensities of counselling and 1 compared individual counselling to group therapy
Studies were not found to be significantly heterogeneous.

The evidence

Outcome Time to outcome CER OR
(95% CI)		 NNT
(95% CI)
quit smoking: counselling v. minimal contact 6 months 194/1899
(10.2%)		 1.55
(1.27 to 1.90) 		21
(13 to 41)
quit smoking: intensive counselling v. brief counselling 6 months 19/179
(106%)		 1.17
(0.59 to 2.34) 		63
(NNT = 9 to infinity;
NNH = 25 to infinity)
quit smoking: counselling v. group sessions 6 months 43/167
(25.7%)		 1.33
(0.83 to 2.13) 		17
(NNT = 6 to infinity;
NNH = 29 to infinity)

Citation

  1. Lancaster T, and Stead LF: individual behavioural counseling for smoking cessation. Cochrane Library 1999; 2 : -
Search Terms: smoking and cessation in Cochrane Library
Contributor: Chris Ball, May 2002
Reviewer:

Clinical Question.
Patient smokers
Intervention or Exposure individual counselling
Outcome quit smoking