Historique
Article de Périodique
Training health professionals in smoking cessation (Review) (2026)
Auteur(s) :
SHARRAD, K. J. ;
CARSON-CHAHHOUD, K. V. ;
VERBIEST, M. E. ;
GREENSLADE, S. ;
PARKHOUSE, T. ;
ASSENDELFT, W. J. ;
CRONE, M. R. ;
LIVINGSTONE-BANKS, J.
Année
2026
Page(s) :
art. CD000214
Sous-type de document :
Revue de la littérature
Langue(s) :
Anglais
Domaine :
Tabac / e-cigarette
Thésaurus mots-clés
ARRET DU TABAC
;
PERSONNEL MEDICAL
;
FORMATION
;
SEVRAGE
;
INTERVENTION
;
ABSTINENCE
;
PRISE EN CHARGE
;
EFFICACITE
Résumé :
Rationale:
Cigarette smoking is one of the leading causes of preventable death worldwide. There is good evidence that brief interventions by health professionals can increase smoking cessation attempts. However, as new studies become available, the effectiveness of these training programmes needs to be re-assessed to inform public policy, clinical care, and guideline recommendations. This is an update of a Cochrane review first published in 2000, and previously updated in 2012.
Objectives:
To assess the effectiveness of training healthcare professionals to deliver smoking cessation interventions to their patients, and to assess the effects of training characteristics (such as content, setting, delivery, and intensity). [...]
Outcomes:
The critical outcome measure was abstinence from smoking six months or more after baseline, using the strictest measure of abstinence available at the longest follow-up. Prolonged or continuous abstinence was preferred over point prevalence. Our important outcome was the number of participants who made a quit attempt. [...]
Synthesis of results:
Sixteen studies compared training of healthcare professionals in smoking cessation to no training, and assessed the effect on the number of participants abstinent at longest follow-up. High-certainty evidence indicates that smoking cessation training for healthcare professionals increases patient smoking cessation compared with no training (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.08 to 1.67; I² = 48%; 16 studies, 16,513 participants). We conducted three subgroup analyses to test the effect of specific potential sources of heterogeneity: training intensity, type of healthcare professional trained, and treatment recommended in the training; none found evidence of between-group heterogeneity.
Four studies assessed the effect of high-intensity training for healthcare professionals on the number of participants abstinent at longest follow-up compared with lower-intensity training. The evidence suggests that higher-intensity training may increase smoking cessation compared with lower-intensity training, though confidence intervals were wide and included the potential for no benefit (RR 1.64, 95% CI 0.86 to 3.12; I² = 54%; 4 studies, 1151 participants; low-certainty evidence).
Three studies assessed the impact of adjuncts to training on the number of participants abstinent at longest follow-up. We found low-certainty evidence that when the healthcare professionals treating them are trained in smoking cessation, more people may quit when also provided with nicotine replacement therapy (RR 1.64, 95% CI 0.72 to 3.71; I² = 69%; 2 studies, 1892 participants), and very low-certainty evidence that providing prompts to healthcare professionals in addition to smoking cessation training may help more people to quit (RR 1.37, 95% CI 0.69 to 2.70; I² = 66%; 3 studies, 2429 participants). However, in both cases, confidence intervals were wide and included the potential for no benefit.
Authors' conclusions:
High-certainty evidence supports the effectiveness of training health professionals in smoking cessation when compared with no training. Multi-component investigations incorporating new pharmacological interventions for smoking cessation (such as varenicline and bupropion) or other cessation aids alongside physician training should be considered to determine if any additional benefit in long-term abstinence can be obtained.
Funding:
Production of this review was supported by PhD scholarship funding from the University of Adelaide and co-funded by Houd Research Group, awarded to KS. [Author's abstract]
Cigarette smoking is one of the leading causes of preventable death worldwide. There is good evidence that brief interventions by health professionals can increase smoking cessation attempts. However, as new studies become available, the effectiveness of these training programmes needs to be re-assessed to inform public policy, clinical care, and guideline recommendations. This is an update of a Cochrane review first published in 2000, and previously updated in 2012.
Objectives:
To assess the effectiveness of training healthcare professionals to deliver smoking cessation interventions to their patients, and to assess the effects of training characteristics (such as content, setting, delivery, and intensity). [...]
Outcomes:
The critical outcome measure was abstinence from smoking six months or more after baseline, using the strictest measure of abstinence available at the longest follow-up. Prolonged or continuous abstinence was preferred over point prevalence. Our important outcome was the number of participants who made a quit attempt. [...]
Synthesis of results:
Sixteen studies compared training of healthcare professionals in smoking cessation to no training, and assessed the effect on the number of participants abstinent at longest follow-up. High-certainty evidence indicates that smoking cessation training for healthcare professionals increases patient smoking cessation compared with no training (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.08 to 1.67; I² = 48%; 16 studies, 16,513 participants). We conducted three subgroup analyses to test the effect of specific potential sources of heterogeneity: training intensity, type of healthcare professional trained, and treatment recommended in the training; none found evidence of between-group heterogeneity.
Four studies assessed the effect of high-intensity training for healthcare professionals on the number of participants abstinent at longest follow-up compared with lower-intensity training. The evidence suggests that higher-intensity training may increase smoking cessation compared with lower-intensity training, though confidence intervals were wide and included the potential for no benefit (RR 1.64, 95% CI 0.86 to 3.12; I² = 54%; 4 studies, 1151 participants; low-certainty evidence).
Three studies assessed the impact of adjuncts to training on the number of participants abstinent at longest follow-up. We found low-certainty evidence that when the healthcare professionals treating them are trained in smoking cessation, more people may quit when also provided with nicotine replacement therapy (RR 1.64, 95% CI 0.72 to 3.71; I² = 69%; 2 studies, 1892 participants), and very low-certainty evidence that providing prompts to healthcare professionals in addition to smoking cessation training may help more people to quit (RR 1.37, 95% CI 0.69 to 2.70; I² = 66%; 3 studies, 2429 participants). However, in both cases, confidence intervals were wide and included the potential for no benefit.
Authors' conclusions:
High-certainty evidence supports the effectiveness of training health professionals in smoking cessation when compared with no training. Multi-component investigations incorporating new pharmacological interventions for smoking cessation (such as varenicline and bupropion) or other cessation aids alongside physician training should be considered to determine if any additional benefit in long-term abstinence can be obtained.
Funding:
Production of this review was supported by PhD scholarship funding from the University of Adelaide and co-funded by Houd Research Group, awarded to KS. [Author's abstract]
Affiliation :
Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
Centre of Expertise Perspective in Health, Avans University of Applied Sciences, Breda, Netherlands.
Respiratory and Sleep, Women's and Children's Hospital, Adelaide, Australia.
Bristol Medical School, University of Bristol, Bristol, UK.
Department of Primary and Community Care, 117 ELG, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
Department of Health Promotion, Maastricht University, Maastricht, Netherlands.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Centre of Expertise Perspective in Health, Avans University of Applied Sciences, Breda, Netherlands.
Respiratory and Sleep, Women's and Children's Hospital, Adelaide, Australia.
Bristol Medical School, University of Bristol, Bristol, UK.
Department of Primary and Community Care, 117 ELG, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
Department of Health Promotion, Maastricht University, Maastricht, Netherlands.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.