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1 Department of Family Medicine, Dankook University Hospital, Chungnam, South Korea
2 Department of Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tenn
3 Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY
4 Departments of Family Medicine and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY
CORRESPONDING AUTHOR: Fred Tudiver, MD, Division of Research and Community Health, Department of Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, Box 70621, Johnson City, TN 37614, tudiverf{at}mail.etsu.edu
ABSTRACT
BACKGROUND We wanted to determine whether an intervention to enhance partner support helps as an adjunct to a smoking cessation program.
METHODS We undertook a meta-analysis of English-language, randomized controlled trials of smoking cessation interventions through July 2002 using the following data sources: Cochrane Tobacco Addiction Group specialized register, Cochrane controlled trials register, CDC Tobacco Information and Prevention Database, MEDLINE, Cancer Lit, EMBASE, CINAHL, PsycINFO, ERIC, PsycLIT, Dissertation Abstracts, SSCI and HealthSTAR, with reviews of bibliographies of included articles. Included were trials that assessed a partner support component with a minimum follow-up of 6 months. The outcomes measured were abstinence and biochemical assessment at 6 to 9 months and more than 12 months after treatment. Partner Interaction Questionnaire scores were primary and secondary outcomes.
RESULTS Nine studies (31 articles) met inclusion criteria. Partner definition varied among studies. All studies included self-reported smoking cessation rates, but there was limited biochemical validation of abstinence. For self-reported abstinence at 6 to 9 months after treatment, the Peto odds ratio (OR) = 1.08 (95% confidence interval [CI], 0.81–1.44) and at 12 months Peto OR = 1.0 (95% CI, 0.75–1.34). Sensitivity analysis of studies using live-in, married, and equivalent-to-married partners found a higher odds ratio at 6 to 9 months after treatment, Peto OR = 1.64 (95% CI, 0.5–4.64). Sensitivity analysis of studies reporting significant increases in partner support found at 6 to 9 months after treatment Peto OR = 1.83 (95% CI, 0.9–3.47); and at 12 months Peto OR =1.22 (95% CI, 0.67–2.23).
CONCLUSIONS Interventions to enhance partner support showed the most promise for clinical practice when implemented with live-in, married, and equivalent-to-married partners. Such interventions should focus on enhancing supportive behaviors, while minimizing behaviors critical of smoking.
Key Words: Smoking • smoking cessation • social support
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