Group behaviour therapy programmes for smoking cessation

Background Group therapy offers individuals the opportunity to learn behavioural techniques for smoking cessation, and to provide each other with mutual support. Objectives To determine the effect of group‐delivered behavioural interventions in achieving long‐term smoking cessation. Search methods We searched the Cochrane Tobacco Addiction Group Specialized Register, using the terms 'behavior therapy', 'cognitive therapy', 'psychotherapy' or 'group therapy', in May 2016. Selection criteria Randomized trials that compared group therapy with self‐help, individual counselling, another intervention or no intervention (including usual care or a waiting‐list control). We also considered trials that compared more than one group programme. We included those trials with a minimum of two group meetings, and follow‐up of smoking status at least six months after the start of the programme. We excluded trials in which group therapy was provided to both active therapy and placebo arms of trials of pharmacotherapies, unless they had a factorial design. Data collection and analysis Two review authors extracted data in duplicate on the participants, the interventions provided to the groups and the controls, including programme length, intensity and main components, the outcome measures, method of randomization, and completeness of follow‐up. The main outcome measure was abstinence from smoking after at least six months follow‐up in participants smoking at baseline. We used the most rigorous definition of abstinence in each trial, and biochemically‐validated rates where available. We analysed participants lost to follow‐up as continuing smokers. We expressed effects as a risk ratio for cessation. Where possible, we performed meta‐analysis using a fixed‐effect (Mantel‐Haenszel) model. We assessed the quality of evidence within each study and comparison, using the Cochrane 'Risk of bias' tool and GRADE criteria. Main results Sixty‐six trials met our inclusion criteria for one or more of the comparisons in the review. Thirteen trials compared a group programme with a self‐help programme; there was an increase in cessation with the use of a group programme (N = 4395, risk ratio (RR) 1.88, 95% confidence interval (CI) 1.52 to 2.33, I2 = 0%). We judged the GRADE quality of evidence to be moderate, downgraded due to there being few studies at low risk of bias. Fourteen trials compared a group programme with brief support from a health care provider. There was a small increase in c