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Training health professionals in smoking cessation

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Abstract

Background

There is good evidence that brief interventions from health professionals can increase rates of smoking cessation. A number of trials have examined whether specific skills training for health professionals leads them to have greater success in helping their patients who smoke.

Objectives

The aim of this review was to assess the effectiveness of training health care professionals to deliver smoking cessation interventions to their patients, and to assess the additional effects of prompts and reminders to the health professional to intervene.

Search methods

We searched the Cochrane Tobacco Addiction Group trials register for studies relating to training.

Selection criteria

Randomised trials in which the intervention was training of health care professionals in smoking cessation. Trials were considered if they reported outcomes for patient smoking rates at least six months after the intervention. We reported on process outcomes, but we excluded trials that reported effects only on process outcomes and not smoking behaviour.

Data collection and analysis

We extracted data in duplicate on the type of health professionals, the nature of and duration of the training, the outcome measures, method of randomisation, and completeness of follow‐up.

The main outcome measures were 1. Rates of abstinence from smoking after at least six months follow‐up in patients smoking at baseline. 2. Rates of performance of tasks of smoking cessation by health care professionals including offering counselling, setting quit dates, giving follow‐up appointments, distributing self‐help materials and recommending nicotine gum.

Main results

Healthcare professionals who had received training were more likely to perform tasks of smoking cessation than untrained controls. Of eight studies that compared patient smoking behaviour between trained professionals and controls, six found no effect of intervention. The effects of training on process outcomes increased if prompts and reminders were used.

Authors' conclusions

Training health professionals to provide smoking cessation interventions had a measurable effect on professional performance. There was no strong evidence that it changed smoking behaviour.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Can quit rates be improved by training health professionals to ask people if they smoke and to offer them advice

Training programs are used to encourage health professionals to ask people if they smoke, and then offer advice to help them quit. The review of trials found that these programs increase the number of people health professionals identify as smokers. The programs also increase the number of people offered advice and support for quitting by health professionals. However, there is not strong evidence that this results in more people quitting smoking.