Annals of epidemiology · 2026
Effectiveness of telephone counseling and quitlines in tobacco cessation: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Raj Sonika, Shabil Muhammed, Sachdeva Meenakshi, Goel Sonu
Аннотация
OBJECTIVES: To evaluate the effectiveness of telephone counselling, including quitlines, for tobacco cessation and to compare outcomes between randomized controlled trials (RCTs) and observational studies across diverse populations and settings.
STUDY DESIGN: Systematic review and meta-analysis METHODS: We systematically searched PubMed, EMBASE, Scopus, Cochrane Library, and ScienceDirect for English-language studies (2002-2025). Eligible studies included RCTs, non-randomized trials, and observational studies of individuals using any form of tobacco. The primary outcome was continuous abstinence; secondary outcomes included 7-day and 30-day point prevalence abstinence. Risk of bias was assessed using the Cochrane RoB-2 and Newcastle-Ottawa Scale; certainty of evidence was rated with GRADE. PROSPERO registration: CRD42023418243.
RESULTS: Thirty-six studies (RCTs=25; observational=11) were included. Across RCTs, telephone counselling increased continuous abstinence by 43% (RR = 1.43; 95% CI: 1.11-1.84; I² = 48%). 7-day PPA improved by 45% (RR = 1.45; 95% CI: 1.13-1.86; I² = 74%), while 30-day PPA (4 RCTs) also showed benefit (RR = 1.37; 95% CI: 1.14-1.65). Subgroup analyses demonstrated consistent effects across biochemical and self-reported verification. Observational studies reported 7-day PPA ranging from 2.6%-67.4%, 30-day PPA around 20.5%, and mean quit rates of 35.5%, with higher cessation among those completing ≥ 3 counselling sessions. Meta-regression indicated that differences between RCT and observational estimates were driven by follow-up duration, not study design.
CONCLUSIONS: Telephone counselling significantly increases quit rates across populations, with evidence from both trial and real-world settings. Scaling up quitline services, particularly in low- and middle-income countries, should be prioritized to strengthen global tobacco control efforts.
STUDY DESIGN: Systematic review and meta-analysis METHODS: We systematically searched PubMed, EMBASE, Scopus, Cochrane Library, and ScienceDirect for English-language studies (2002-2025). Eligible studies included RCTs, non-randomized trials, and observational studies of individuals using any form of tobacco. The primary outcome was continuous abstinence; secondary outcomes included 7-day and 30-day point prevalence abstinence. Risk of bias was assessed using the Cochrane RoB-2 and Newcastle-Ottawa Scale; certainty of evidence was rated with GRADE. PROSPERO registration: CRD42023418243.
RESULTS: Thirty-six studies (RCTs=25; observational=11) were included. Across RCTs, telephone counselling increased continuous abstinence by 43% (RR = 1.43; 95% CI: 1.11-1.84; I² = 48%). 7-day PPA improved by 45% (RR = 1.45; 95% CI: 1.13-1.86; I² = 74%), while 30-day PPA (4 RCTs) also showed benefit (RR = 1.37; 95% CI: 1.14-1.65). Subgroup analyses demonstrated consistent effects across biochemical and self-reported verification. Observational studies reported 7-day PPA ranging from 2.6%-67.4%, 30-day PPA around 20.5%, and mean quit rates of 35.5%, with higher cessation among those completing ≥ 3 counselling sessions. Meta-regression indicated that differences between RCT and observational estimates were driven by follow-up duration, not study design.
CONCLUSIONS: Telephone counselling significantly increases quit rates across populations, with evidence from both trial and real-world settings. Scaling up quitline services, particularly in low- and middle-income countries, should be prioritized to strengthen global tobacco control efforts.