Non-pharmacological and Pharmacological Intervention for Smoking Cessation Programs in Youth: A Review of Clinical Effectiveness and Guidelines

Key Message

Three systematic reviews, nine randomized controlled trials, and two guidelines were identified that addressed the research questions, and the results were mixed.

One randomized controlled trial was identified and provided results regarding the clinical effectiveness of pharmacological and non-pharmacological smoking interventions for youth. Evidence from this randomized controlled trial suggested that there were no significant differences in smoking cessation or smoking frequency outcomes between brief advice, nicotine patch therapy and a 6-week text messaging intervention (intervention) and brief advice and nicotine patch therapy (control).

Three systematic reviews and eight randomized controlled trials were identified and examined the clinical effectiveness a variety of different non-pharmacological smoking interventions for youth. Evidence from the systematic reviews did not reveal improved smoking cessation outcomes for most comparisons; two comparisons via meta-analyses did find improved smoking cessation outcomes in favour of the intervention. Of the seven randomized controlled trials that examined smoking cessation outcomes, three studies found reductions in favour of the smoking cessation intervention, three did not find differences between groups, and one study found improvements at 3-months in favour of the intervention but not at 6-month follow-up. Mixed findings were found for other key clinical outcomes, such as smoking behaviour and quitting outcomes.

Two evidence-based guidelines regarding smoking cessation interventions for youth were identified; one guideline was commissioned by National Institute for Health and Care Excellence and the other by the Canadian Task Force on Preventive Health Care. The National Institute for Health and Care Excellence guideline recommends the consideration of nicotine replacement therapy for young people who are dependent on nicotine (strength of recommendation: weak); if nicotine replacement therapy is prescribed, the guideline recommends offering it with behavioural support (strength of recommendation: strong). The Canadian Task Force on Preventive Health Care guidelines recommend asking children and youth smokers or their parents about tobacco use by the child or youth and offering brief information and advice during primary care visits (strength of recommendation: weak). Both guidelines used rigorous methodology to inform their recommendations, but the studies included to inform the recommendations were of varying quality, ranging from low to moderate quality.

It may be premature to draw conclusions about pharmacological and non-pharmacological smoking cessation interventions for youth given the mixed findings identified in this report.