Review and special article
Efficacy of Smoking-Cessation Interventions for Young Adults: A Meta-Analysis

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Context

Approximately 22% of U.S. young adults (aged 18–24 years) are smokers. Young adults typically display an interest in quitting, but it is unknown whether the evidence-based cessation programs designed for adults will be equally effective for young adults. This meta-analysis investigated the efficacy of smoking-cessation programs for this population.

Evidence acquisition

In 2009–2011, studies published between 2004 and 2008 that investigated smoking cessation were first found through the DHHS Clinical Practice Guidelines for Treating Tobacco Use and Dependence as well as a PubMed search (2009–2010) and were then subjected to a rigorous inclusion process. Authors were contacted to glean raw data for young adults. Fourteen studies provided data that were coded for descriptive information and aggregated using the Comprehensive Meta-Analysis, version 2.0.

Evidence synthesis

Among young adults, any type of intervention was more effective in producing successful smoking cessation than the control. This was the case for intent-to-treat analyses as well as complete cases. When interventions were effective for the larger adult sample, they were also effective for the younger adult sample.

Conclusions

Although young adults tend to underutilize evidence-based cessation treatments, the current meta-analysis showed that these treatments should be as effective for young adults as they are for the general adult population. Thus, it may be useful to focus on motivating young adults to seek cessation treatment to increase utilization.

Section snippets

Context

Historically, almost all adult smokers begin smoking as adolescents,1 but smoking becomes more entrenched during young adulthood (i.e., ages 18–24 years),2, 3, 4 and initiation into smoking is also not uncommon during this developmental period. This combination of initiation and escalation of smoking produces smoking prevalence equivalent to that of older age groups; in 2009, 21.8% of those aged 18–24 years in the U.S. were current smokers.5

Despite the increasing prevalence of smoking from

Selection Process/Inclusion Criteria

Search, selection, and coding of relevant studies followed the PRISMA checklist.13 In 2009, potential studies initially were identified through two routes: (1) systematically reviewing studies included in the latest revision of the Clinical Practice Guidelines,9 which included comprehensive meta-analyses of peer-reviewed RCCTs of tobacco use interventions with a minimum of 5 months' follow-up for studies published between 2004 and 2008; and (2) a systematic literature search for relevant

Evidence Synthesis

Table 1 presents relevant information (i.e., study authors, publication date, sample size, nature of cessation treatment, ORs for comparison of treatment with control) about the 14 studies (with 20 total effect sizes), which were included for analysis. Some studies involved multiple treatment conditions, resulting in more outcomes than studies, which introduces non-independence in the meta-analyses. According to Hunter and Schmidt,32 however, a violation of independence is unlikely to cause

Discussion

Aggregating all study outcomes indicated that interventions (versus controls) were associated with higher odds of smoking cessation in young adults. The results for subsamples of those aged 18–24 years followed those of the parent studies: in cases where there was an overall treatment effect for all ages in the parent study, there was similarly an effect for the young adult group, but no treatment effect for the subsample of young adults when the parent study found no treatment effect. The

Conclusion

It is encouraging to find that young adults can benefit from existing treatments for smoking cessation. Encouraging a greater proportion of young adults to seek out these evidence-based treatments and perhaps more-tailored marketing of these effective treatments to this population may help to further reduce the prevalence of smoking among this age group.

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