Podcast: Are there any smoking cessation programmes that can help adolescents to stop smoking?

The Cochrane Tobacco Addiction Group has produced dozens of reviews of the effects of a wide variety of interventions to help smokers quit. The reviews are updated periodically to incorporate new evidence and the second update of the review focusing on interventions for young people was published in November 2017. Lead author, Tom Fanshawe from the Nuffield Department of Primary Care Health Sciences in the University of Oxford in the UK bring us up to date with the findings.

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John: Hello, I'm John Hilton, editor in the Cochrane Editorial and Methods department. The Cochrane Tobacco Addiction Group has produced dozens of reviews of the effects of a wide variety of interventions to help smokers quit. The reviews are updated periodically to incorporate new evidence and the second update of the review focusing on interventions for young people was published in November 2017. Lead author, Tom Fanshawe from the Nuffield Department of Primary Care Health Sciences in the University of Oxford in the UK bring us up to date with the findings.

Tom: Many people who start smoking tobacco when they are teenagers continue to smoke as adults. Those who start smoking early in life are at particularly high risk of becoming addicted to nicotine and later developing diseases like lung cancer. However, we know that many teenagers who take up smoking want to quit and so we have brought together the relevant research into ways to help them succeed.
We found 41 randomized trials of interventions aimed at helping young smokers to stop. These included around 13,000 people, most of them from North America, with very few studies in lower income countries, even though teenage smoking rates are now much higher in those countries than in wealthier countries.
The trials tested a wide range of interventions, including person-to-person counselling, group counselling, and interventions that were computer-based or used text messaging. Six studies used drug treatments, either on their own or combined with a form of counselling. None of the available studies looked at electronic cigarettes as an aid to quitting.
Taking our results overall, we cannot currently identify any single programme for helping young people to stop smoking that is more successful than trying to stop unaided. This is partly due to the low quality of evidence we found but many of the studies were also very different in the types of interventions they used, which makes comparing or combining their results difficult.
Some group-based counselling interventions appear to show promise but even though we estimated that these could produce a 35% increase in successful quit attempts, this finding is based on rather low-quality evidence, and the effectiveness appears somewhat lower than when similar interventions have been used with adults.
In considering the past and looking to the future, we know that carrying out trials of quitting smoking in young people is especially difficult. Many young smokers use tobacco only occasionally, and not with a particular pattern, which can make developing interventions more challenging. Many of the existing studies also had lots of people dropping out, and used different ways for measuring whether a quit attempt had been successful.
In summary, therefore, although there is a growing amount of evidence about interventions to try to help teenagers stop smoking and the benefits of quitting are well established, the best way to help young smokers quit remains unclear. More studies are needed in this age group to see how effective new interventions are as these become available.

John: If you would like to find out more about the current evidence and watch for the next update of this review should these new studies become available, visit the Cochrane Library dot com and search 'tobacco cessation for young people'. Tom’s review will appear at the top of the list.

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