Smoking-cessation interventions by type of provider: a meta-analysis.
OBJECTIVE
To synthesize the evidence on the effectiveness of smoking-cessation interventions by type of provider.


METHODS
A random effects meta-regression was estimated to examine the effect of provider and whether the intervention contained nicotine replacement therapy (NRT), on the intervention's relative risk of quitting as compared to placebo or usual care from studies published in databases from inception to 2000. Thirty additional studies not included in the previous 1996 and 2000 U.S. Public Health Service clinical practice guidelines were used to provide the most comprehensive analysis to date of the comparative effectiveness of different types of providers in interventions for smoking cessation that have been published.


RESULTS
The effectiveness without NRT follows: psychologist (1.94, 95% confidence interval [CI]: 1.04-3.62); physician (1.87, CI=1.42-2.45); counselor (1.82, CI=0.84-3.96); nurse (1.76, CI=1.21-2.57); unknown (1.27, CI=0.57-2.82); other (1.18, CI=0.67-2.10); and self-help (1.28, CI=0.89-1.82). Effectiveness of most providers increased by almost twofold with the use of NRT.


CONCLUSIONS
Smoking-cessation interventions without NRT delivered by psychologists, physicians, or nurses are all effective. NRT increases the effectiveness of most providers.
Mojica
Walter A
WA
Southern California Evidence-Based Practice Center, RAND Health Division, Santa Monica, California, USA. Walter_Mojica@rand.org
Suttorp
Marika J
MJ
Sherman
Scott E
SE
Morton
Sally C
SC
Roth
Elizabeth A
EA
Maglione
Margaret A
MA
Rhodes
Shannon L
SL
Shekelle
Paul G
PG
D003376:Counseling; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage; D018722:Nicotinic Agonists / Q000008:administration & dosage; D024802:Nurse's Role; D010043:Outcome and Process Assessment, Health Care; D010819:Physician's Role; D011584:Psychology; D016540:Smoking Cessation / Q000379:methods*
D018722:Nicotinic Agonists; D009538:Nicotine