Review and special articleEfficacy of Smoking-Cessation Interventions for Young Adults: A Meta-Analysis
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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2021, Addictive BehaviorsCitation Excerpt :Supporting evidence in the adult population (Hajek et al., 2019), a single randomized controlled trial of 99 young adult daily smokers in 2014 found that using nicotine-containing e-cigarettes was associated with a 220% higher odds of achieving a 50% reduction in the number of cigarettes smoked per day compared to placebo e-cigarettes (Tseng et al., 2016). While increasing use of evidence-based cessation treatments in young adults (e.g., text message interventions, sustained quit-and-win contests, multiple behavior interventions) remains a tobacco control priority, identifying new cessation alternatives is key, given the high frequency of failed quit attempts in this age group and the importance of quitting at an early age in minimizing the risk of smoking-attributable morbidity and mortality (Fanshawe et al., 2017; Kenfield et al., 2008; Babb et al., 2017; Suls et al., 2012; Villanti et al., 2020). Observational studies in the United States (U.S.) suggest that e-cigarette use is unlikely to be associated with positive changes in smoking among young adults because young smokers are less likely than older age groups to use them as cessation aids (Spears et al. Jul, 2019; Biener et al., 2015; Patel et al., 2016; Olfson et al., 2019).
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2020, American Journal of Preventive MedicineCitation Excerpt :This review highlights the promise of 3 approaches for young adult cessation not included in the prior review: text message interventions, sustained quit-and-win contests, and multiple behavior interventions. With previous evidence on the effectiveness of general adult interventions for smoking cessation in young adults,17 the findings support the extension of population-level services, like quitlines, to improve young adult cessation, although data suggest that young people do not call quitlines.70 They also speak to the potential for remote interventions (e.g., web-based and text message) to improve the reach of cessation interventions to this population.
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2020, Journal of Substance Abuse TreatmentCitation Excerpt :Likewise, young adults were less likely to report using evidence-based cessation treatments (e.g., counseling or medications) which increased the likelihood of successful cessation (Babb et al., 2017). Given a recent meta-analysis showed that these evidence-based cessation treatments are efficacious in promoting smoking cessation among young adult smokers (Suls et al., 2012), promoting the use of evidence-based smoking cessation treatments, especially among non-college educated young adult smokers from racial/ethnic minority populations, should be an important public health goal. Health behavioral theories posit that perceptions and beliefs about a health behavior predict intention to engage and subsequently engaging with the health behavior (Ferrer & Klein, 2015).
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