title: [Recommendations for smoking cessation in Colombia].
abstract: BACKGROUND
  Chronic diseases represent the greatest burden of disease in Colombia for which smoking is the major risk factor.
  
  
  OBJECTIVE
  To provide clinical practice recommendations based upon efficacy and safety of smoking cessation therapies for Colombian adults.
  
  
  METHODS
  An adaptation of clinical practice guidelines (CPG) based on the ADAPT methodology was performed. We searched CPG on Medline, EMBASE, CINAHL, LILACS, and Cochrane databases. Six months' cessation rates were appraised for brief and intensive counseling, nicotine replacement therapy (NRT), bupropion, varenicline, clonidine, nortriptyline, acupuncture, hypnosis, homeopathy, and combined treatments. CPG were evaluated with DELBI and selected when having a score above 60% for methodological rigor of development and applicability to the Colombian health system. Formal consensus was performed for questions without strong evidence.
  
  
  RESULTS
  925 references were found, 17 CPG were pre-selected and 5 selected for adaptation. Brief and intensive counseling, NRT, bupropion, nortriptyline, and varenicline are effective for smoking cessation (cessation rates augment 5.1%-22.7%). Alternative therapies have not demonstrated cessation efficacy. Concomitant use of different NRT is the only combination with demonstrated efficacy (OR 1.9, 95%CI 1.3-2.7).
  
  
  CONCLUSIONS
  Several alternatives for giving up tobacco smoking have confirmed efficacy. The absolute difference in cessation rates is variable among therapies and duration of effect requires further research. Brief and intensive counseling necessitate standardized formats for their implementation in Colombia. Economic evaluations are required to assess costs and benefits and to select the most suitable interventions for Colombia.
authors.affiliation: Departamento de Medicina Preventiva y Social, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors.forename: Luz Helena
authors.initials: LH
authors.lastname: Alba
authors.affiliation: Subdirección de Investigaciones, Instituto Nacional de Cancerología, Bogotá, D.C, Colombia.
authors.forename: Raúl
authors.initials: R
authors.lastname: Murillo
authors.affiliation: Consultorios Médicos Universitarios, Hospital Universitario de San Ignacio, Bogotá, D.C, Colombia.
authors.forename: Nelci
authors.initials: N
authors.lastname: Becerra
authors.affiliation: Fundación Neumológica Colombiana, Bogotá, D.C, Colombia.
authors.forename: Nelson
authors.initials: N
authors.lastname: Páez
authors.affiliation: Unidad de Neumología, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Cañas
authors.affiliation: Departamento de Medicina Preventiva y Social, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors.forename: Catalina
authors.initials: C
authors.lastname: Mosquera
authors.affiliation: Grupo de Investigación Clínica, Instituto Nacional de Cancerología, Bogotá, D.C, Colombia.
authors.forename: Juan Sebastián
authors.initials: JS
authors.lastname: Castillo
authors.affiliation: Departamento de Medicina Preventiva y Social, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Camacho
authors.affiliation: Departamento de Medicina Preventiva y Social, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors.forename: Javier
authors.initials: J
authors.lastname: Gómez
authors.affiliation: Unidad de Neumología, Instituto Nacional de Cancerología, Bogotá, D.C, Colombia.
authors.forename: Plutarco
authors.initials: P
authors.lastname: García-Herreros
authors.affiliation: Departamento de Medicina Preventiva y Social, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors.forename: Luis Gabriel
authors.initials: LG
authors.lastname: Bernal
mesh_terms: D003105:Colombia; D006801:Humans; D017410:Practice Guidelines as Topic; D016540:Smoking Cessation / Q000379:methods*