A Review of Smoking Cessation Interventions

Ashish Maseeh, MD, and Gagandeep Kwatra, MD

Disclosures
In This Article

Alternative Interventions

There is no clear evidence that strategies such as acupuncture, acupressure, laser therapy, and electrostimulation are effective for smoking cessation.[22] Exercise programs have been projected as adjuncts to cessation programs. While exercise may reduce the weight gain, there is no clear evidence of benefit in smoking cessation with exercise.[2] Only 1 trial reported an improvement in abstinence rates,[22] but confirmation would require further investigation in larger studies.[93] For patients with particular concerns or who are already overweight, it may be better to combine cessation with exercise.[94] Aversive smoking using silver acetate has been tried, but its specific efficacy is doubtful because of poor compliance with a treatment whose rationale is to create an unpleasant stimulus.[95]

An estimated 70% of the smokers see a physician each year, providing physicians with substantial opportunity to influence smoking behavior.[96] A physician's advice increases smoking cessation rates by approximately 30%[19] and should be given opportunistically by health professionals to smokers whether or not they are trying to quit.[23] Approximately 40% of smokers try to quit smoking in response to this advice,[97] and up to 3% succeed.[18] Counseling can be administered personally, by telephone,[18] in pamphlets and booklets, audiotapes, videotapes, and computer programs.[22] Both individual counseling and group therapy increase the chances of quitting.[98,99]

Cognitive behavioral therapies constitute most counseling programs and comprise identification of cues for smoking and then developing methods to break the link between the cues and smoking. They also develop strategies for coping with stress and managing symptoms of nicotine withdrawal.[22]

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