| Sumario: | Question: How effective are self help smoking cessation interventions? Data sources: Studies were identified by searching the Tobacco Addiction Review Group Register (which includes studies identified from Medline, PsycLIT, Dissertation Abstracts Online, Applied Social Sciences Index and Abstracts, Social Citations Index. and Social Science Citations Index) using the terms self help, manual, and booklet; and bibliographies of previous reviews. Study selection: Randomised or quasi-randomised controlled trials were selected if they had >/= 6 months follow up and if >/= 1 treatment arm involved a self help intervention without repeated face to face contact with a therapist. Self help interventions had to involve a structured programme for quitting. Studies of pregnant women were excluded. Data extraction: Data were extracted on the study population, method of randomisation, type of intervention, follow up, and validation of self reported cessation. Main results: Meta-analysis of 10 trials of self help compared with no self help found no differences for smoking cessation at longest follow up (p=0.06) (table). When 3 trials in which the control group received some form of leaflet were excluded from the analysis, the self help group had slightly higher cessation rates (p<0.04) (table). Adding self help to advice or to nicotine replacement therapy did not increase smoking cessation. Several studies assessed enhancements to self help interventions. Meta-analysis of 6 studies showed that personalised self help materials increased smoking cessation compared with standard materials (6.2% v 4.3%, relative benefit increase [RBI] 49%, 95% CI 12 to 98, number needed to treat [NNT] 53, CI 33 to 147). Meta-analysis of 6 studies showed that self help materials with telephone follow up increased smoking cessation (11.4% v 7.9%, RBI 55%, CI 30 to 85, NNT 29, CI 20 to 50). Conclusions: Self help interventions alone minimally increase smoking cessation rates. Self help materials added to nicotine replacement therapy or to advice do not confer additional benefits. Self help interventions that are personalised to individual smokers or are supplemented with telephone follow up improve smoking cessation.
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