Non-pharmacological interventions for tobacco cessation: A systematic review of existing practices and their effectiveness

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Submitted: February 8, 2022
Accepted: March 8, 2022
Published: March 25, 2022
Abstract Views: 2544
PDF: 881
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Smoking tobacco is associated with lung cancer and other life-threatening diseases which requires serious action to curb it. Tobacco cessation interventions are available as pharmacological and non-pharmacological methods or a combination of both. The present review examines the effectiveness of the existing non-pharmacological tobacco cessation interventions and synthesizes the result for the future development of drug-free treatment in the community for tobacco cessation. The literature search was conducted in August 2020, using two electronic databases (PubMed and JSTOR), with search terms: [‘tobacco cessation’ OR ‘smoking cessation’] AND [‘intervention’] which included studies published during 2010 and 2020 (till 31st July 2020). All studies were limited to English language, human participants and excluded patients with comorbidities. A total of 2,114 publications were retrieved out of which 11 articles were reviewed. On the basis of intervention used in reviewed studies, we categorized them into seven categories: i. incentive-based intervention, ii. exercise based, iii. telephone-based proactive counselling, iv. mobile phone SMS (Short Message Service) based, v. smartphone app (application) based, vi. web-based intervention, vii. self-help material. Incentives were provided in most of the studies to maintain the retention rate and motivate the participants for completing follow-up. Non-pharmacological interventions for tobacco cessation include a combination of various elements. Our findings suggest that behavioural counselling is one of the most important elements of any non-pharmacological intervention. In addition to behaviour counselling, yoga and exercises along with self-help material, video and phone counselling may have higher efficacy. Thus, practicing non-pharmacological interventions may also increase the cessation rate and reduce the tobacco use burden.



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World Health Organization. WHO Report on the Global Tobacco Epidemic, 2008: the MPOWER package. 2008. Available from:
World Health Organization. Tobacco. 2021. Available from:
Indiatimes [Internet]. World No Tobacco Day: India is home to 12% of the world’s smokers, 10 lakh die every year! 2018. [cited 2021 Dec 31]. Available from:
Global Adult Tobacco Survey. Global Adult Tobacco Survey GATS 2 India 2016-2017 Report. Ministry of Health and Family Welfare, Government of India. 2017.
World Health Organization. India tobacco factsheet 2018 R4. 2018 Available from:
Foundation for a Smoke-Free World [Internet]. The Tobacco Epidemic in India - Foundation for smokefree world. 2019. [cited 2022 Jan 8]. Available from:
Ahluwalia IB, Tripp AL, Dean AK, et al. Tobacco smoking cessation and quitline use among adults aged ≥15 years in 31 countries: Findings from the global adult tobacco survey. Am J Prevent Med 2021;60:S128–35. DOI:
World Health Organization. Training for tobacco quit line counsellors: telephone counselling. 2014. Available from:
Castaldelli-Maia JM, Harutyunyan A, Herbec A, et al. Tobacco dependence treatment for special populations: challenges and opportunities. Braz J Psychiatry 2021;43:75–82. DOI:
CASP C. CASP qualitative checklist. Critical Appraisal Skills Programme. 2018.
Hwang G-S, Jung H-S, Yi Y, et al. Smoking cessation intervention using stepwise exercise incentives for male workers in the workplace. J Public Health 2012;24:82–90. DOI:
Bottorff JL, Oliffe JL, Sarbit G, et al. Evaluation of quitnow men: An online, men-centered smoking cessation intervention. J Med Internet Res 2016;18:e83. DOI:
Bock BC, Dunsiger SI, Rosen RK, et al. Yoga as a complementary therapy for smoking cessation: Results from BreathEasy, a randomized clinical trial. Nicotine Tob Res 2019;21:1517–23. DOI:
Danaher BG, Tyler MS, Crowley RC, et al. Outcomes and device usage for fully automated internet Interventions designed for a smartphone or personal computer: The MobileQuit smoking cessation randomized controlled trial. J Med Internet Res 2019;21:e13290. DOI:
Bricker JB, Mull KE, Kientz JA, et al. Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug Alcohol Depend 2014;143:87–94. DOI:
Bricker J, Wyszynski C, Comstock B, Heffner JL. Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine Tob Res 2013;15:1756–64. DOI:
Zhu SH, Cummins SE, Wong S, et al. The effects of a multilingual telephone quitline for Asian smokers: A randomized controlled trial. J Natl Cancer Inst 2012;104:299–310. DOI:
Myung S-K, Seo HG, Park EC, et al. An observational study of the Korean proactive quitline service for smoking cessation and relapse prevention. Public Health Rep 1974;126:583-90. DOI:
Gram IT, Larbi D, Wangberg SC. Comparing the efficacy of an identical, tailored smoking cessation intervention delivered by mobile text messaging versus email: Randomized controlled trial. JMIR Mhealth Uhealth 2019;7:e12137. DOI:
Bindhim NF, McGeechan K, Trevena L. Smartphone Smoking Cessation application (SSC App) trial: A multicountry double-blind automated randomised controlled trial of a smoking cessation decision-aid “app.” BMJ Open 2018;8:e017105.
Junnual N, Chaikoolvatana A, Suebsamran P, et al. Evaluation of quit-calendar in smoking cessation at Sapasithiprasong hospital, Ubon Ratchathani. Southeast Asian J Trop Med Public Health. 2015;46:155-67.
World Health Organization. WHO global report on trends in prevalence of tobacco use 2000-2025. 2019. Available from:
Marteau TM, Ashcroft RE, Oliver A. Using financial incentives to achieve healthy behaviour. BMJ 2009;338:983–5. DOI:
Oliver A. Can financial incentives improve health equity? BMJ 2009;339:705. DOI:
Resnik DB. Bioethical issues in providing financial incentives to research participants. Medicoleg Bioeth 2015;5:35-41. DOI:
Boyd KA, Briggs AH, Bauld L, et al. Are financial incentives cost‐effective to support smoking cessation during pregnancy? Addiction 2016;111:360–70. DOI:
Christie B. Scottish NHS offers cash to get smokers to quit. BMJ 2009;338:b1306. DOI:
Allan C, Radley A, Williams B. Paying the price for an incentive: An exploratory study of smokers’ reasons for failing to complete an incentive based smoking cessation scheme. J Health Serv Res Policy 2012;17:212–8. DOI:
Klinsophon T, Thaveeratitham P, Sitthipornvorakul E, Janwantanakul P. Effect of exercise type on smoking cessation: a meta-analysis of randomized controlled trials. BMC Res Note. 2017;10:1–21. DOI:
Ussher MH, Taylor AH, Faulkner GEJ. Exercise interventions for smoking cessation. Cochrane Database Syst Rev 2019;2019:CD002295. DOI:
Ussher M, Nunziata P, Cropley M, West R. Effect of a short bout of exercise on tobacco withdrawal symptoms and desire to smoke. Psychopharmacology 2001;158:66–72. DOI:
Lichtenstein E, Zhu SH, Tedeschi GJ. Smoking cessation quitlines: An underrecognized intervention success story. Am Psychol 2010;65:252–61. DOI:
Benowitz NL, Bernert JT, Foulds J, et al. Biochemical verification of tobacco use and abstinence: 2019 update. Nicotine Tob Res 2020;22:1086–97. DOI:
Glasgow RE, Mullooly JP, Vogt TM, et al. Biochemical validation of smoking status: pros, cons, and data from four low-intensity intervention trials. Addict Behav 1993;18:511–27. DOI:
Lillard DR, Plassmann V, Kenkel D, Mathios A. Who kicks the habit and how they do it: socioeconomic differences across methods of quitting smoking in the USA. Social Sci Med 2007;64:2504–19. DOI:
Smith DK, Miller DE, Mounsey A. PURLs: “Cold turkey” works best for smoking cessation. J Family Pract 2017;66:174–6.
World Health Organization. Toolkit for oral health professionals to deliver brief tobacco interventions in primary care. 2017. Available from:
Elshatarat RA, Yacoub MI, Khraim FM, et al. Self-efficacy in treating tobacco use: A review article. Proc Singapore Healthcare 2016;25:243–8. DOI:
Livingstone‐Banks J, Ordóñez‐Mena JM, Hartmann‐Boyce J. Print‐based self‐help interventions for smoking cessation. Cochrane Database Syst Rev 2019;1:CD001118. DOI:
Hartmann‐Boyce J, Lancaster T, Stead LF. Print‐based self‐help interventions for smoking cessation. Cochrane Database Syst Rev 2014;(6):CD001118. DOI:
Simmons VN, Sutton SK, Medina-Ramirez P, et al. Self-help smoking cessation intervention for Spanish-speaking Hispanics/Latinxs in the United States: A randomized controlled trial. Cancer 2022;128:984-94. DOI:

How to Cite

Saroj, Shyam Kanhaiya, and Tushti Bhardwaj. 2022. “Non-Pharmacological Interventions for Tobacco Cessation: A Systematic Review of Existing Practices and Their Effectiveness”. Monaldi Archives for Chest Disease 92 (4).