Effectiveness of psychological interventions for smoking cessation among incarcerated population: A systematic review and meta-analysis (2025)

Objective: The prevalence of smoking is disproportionately high in correctional settings. This systematic review and meta-analysis evaluated the efficacy of psychological interventions in promoting smoking cessation among individuals who are currently incarcerated.
Method: We systematically searched four databases (PubMed, PsycInfo, Web of Science, and Embase) studies assessing the effectiveness of psychological interventions on smoking cessation. Two meta-analyses were conducted: (1) abstinence rates between psychological interventions and control groups in Randomised Controlled Trials (RCTs), and (2) a pooled analysis of abstinence rates after psychological intervention across follow-up periods. Meta-regression was used to examine the effect of follow-up duration on abstinence.
Results: 11 studies (N = 2688), including seven RCTs, met the inclusion criteria. Psychological interventions were associated with a significant increase in smoking abstinence compared with control conditions (OR = 3.41, 95% CI [1.34, 8.70], z = 2.57; p < .05). Yet, this effect was highly heterogeneous (I² = 85.4%) and became non-significant after adjustment for publication bias (OR = 1.60, 95% CI [0.51, 5.07]). The pooled post-intervention abstinence rate across follow-up periods was 18.8% (95% CI [15.5, 22.1]), with moderate to high heterogeneity (I² = 56.1%, τ² = 0.1356). Meta-regression revealed a significant decline in abstinence rates over time (log-odds = -0.0099, SE = 0.0051, p = 0.050).
Conclusions: Psychological interventions show promise but are limited by high heterogeneity, small sample sizes, and methodological weaknesses. More rigorous and adequately powered studies are needed to establish their effectiveness in correctional settings. [Author's abstract]