• Christopher Chi Wai Cheng, Wan Jia Aaron He, Hebe Gouda, Min Jin Zhang, Tzu Tsun Luk, Man Ping Wang, Tai Hing Lam, ChanSophia Siu CheeSSCSchool of Nursing, the University of Hong Kong, Hong Kong, China., and CheungYee Tak DerekYTD0000-0002-5850-5349School of Nursing, the University of Hong Kong, Hong Kong, China. derekcheung@hku.hk..
• School of Nursing, the University of Hong Kong, Hong Kong, China.
• J Gen Intern Med. 2024 Jul 1; 39 (9): 172117341721-1734.

BackgroundVery brief advice (VBA; ≤ 3 min) on quitting is practical and scalable during brief medical interactions with patients who smoke. This study aims to synthesize the effectiveness of VBA for smoking cessation and summarize the implementation strategies.MethodsWe searched randomized controlled trials aiming at tobacco abstinence and comparing VBA versus no smoking advice or no contact from Medline, Embase, CINAHL, Cochrane Library, PsycInfo databases, six Chinese databases, two trial registries ClinicalTrials.gov and WHO-ICTRP from inception to September 30, 2023. Grading of Recommendations, Assessment, Development, and Evaluations framework was used to assess the certainty of the evidence of the meta-analytic findings. The outcomes were self-reported long-term tobacco abstinence at least 6 months after treatment initiation, earlier than 6 months after treatment initiation, and quit attempts. Effect sizes were computed as risk ratio (RR) with 95% CI using frequentist random-effect models.Data SynthesisThirteen randomized controlled trials from 15 articles (n = 26,437) were included. There was moderate-certainty evidence that VBA significantly increased self-reported tobacco abstinence at ≥ 6 months in the adjusted model (adjusted risk ratio ARR 1.17, 95% CI: 1.07-1.27) compared with controls. The sensitivity analysis showed similar results when abstinence was verified by biochemical validation (n = 6 studies, RR 1.53, 95% CI 0.98-2.40). There was high-certainty evidence that VBA significantly increased abstinence at < 6 months (ARR 1.22, 95% CI: 1.01-1.47). Evidence of effect on quit attempts (ARR 1.03, 95% CI 0.97-1.08) was of very low certainty.DiscussionVBA delivered in a clinical setting is effective in increasing self-reported tobacco abstinence, which provides support for wider adoption in clinical practice.© 2024. The Author(s).

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