Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women
Note: This is a draft Research Plan. This draft is distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF.
The final Research Plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Report will form the basis of the USPSTF Recommendation Statement on this topic.
This draft Research Plan is available for comment from November 7 until December 4, 2013 at 5:00 p.m., ET. You may wish to read the entire Research Plan before you comment.
I. Proposed Analytic Framework
II. Proposed Key Questions to Be Systematically Reviewed
- Do tobacco cessation interventions improve mortality, morbidity, and other health and social outcomes in current adult tobacco users, including pregnant women and individuals with mental health conditions?
- Do tobacco cessation interventions achieve tobacco abstinence in current adult tobacco users, including pregnant women and individuals with mental health conditions?
- What adverse events are associated with tobacco cessation interventions?
III. Proposed Contextual Question
The contextual question will not be systematically reviewed and is not shown in the Analytic Framework.
- What is the efficacy and safety of electronic cigarettes as an aid for smoking cessation in current adult smokers?
IV. Proposed Research Approach
The Proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Report. Criteria are overarching as well as specific to each of the key questions (KQs).
|Study Design||Systematic reviews, including review-of-reviews, with or without meta-analysis
A review will be considered “systematic” if it: 1) includes a clear statement of the purpose of the review; 2) describes the search strategy; 3) indicates the criteria used to select studies for inclusion; and 4) presents the findings relevant to the main purpose of the review, including those that did not favor the intervention. Systematic reviews that include experimental and/or observational study designs will be included
|Aim||Tobacco cessation in current tobacco users||
|Condition||Current use of any tobacco product, including, but not limited to: cigarettes, pipes, cigars, cigarillos, little cigars, bidis, kreteks, tobacco (including chew, snuff [including snus], and dissolvable tobacco in the form of strips, sticks, or lozenges), or smoking tobacco through a hookah or waterpipe|
|Population||Adults (age ≥18 years), including pregnant women, who are current smokers
Includes reviews that focus on specific primary care–relevant subgroups (e.g., young adults; specific racial/ethnic groups; lesbian, gay, bisexual, and transgender individuals; veterans)
|Reviews in which >50% of the included studies focus on:
|Interventions||Primary care–relevant tobacco cessation interventions, including behavioral counseling and/or pharmacotherapy, with or without referral
|Setting||Any setting applicable to primary care||Reviews limited to studies that take place in worksites, specialty care, or other settings not applicable to primary care|
|Outcome Assessment||Based on self-report or biochemically validated reports (e.g., expired carbon monoxide; cotinine measured in saliva, urine, or blood; cotinine–creatinine ratio; thiocyanate)||Population-based smoking rates (i.e., not based on study sample, but on underlying population)|
|Outcomes||KQ 1: Health, social, and other outcomes
KQ 2: Behavioral outcomes
KQ 3: Adverse events
|Reviews that only report:
|Outcome assessment timing||KQs 1, 2: ≥6-month followup after quit date/start of intervention
KQ 3: Harms reported at any point after quit date
|<6-month followup after quit date/start of intervention|
|Study geography||Reviews that do not exclusively take place in nondeveloped countries (http://hdr.undp.org/en/statistics)||Reviews in which >50% of included studies take place in countries with a Human Development Index below “Very High”|
|Publication language||English||Any language other than English|
|Publication date||2008 to present||Reviews published before 2008|
|Quality rating||Fair or good||Poor|
AHRQ Publication No. 14-05200-EF-5
Current as of November 2013
U.S. Preventive Services Task Force. Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: Draft Research Plan. AHRQ Publication No. 14-05200-EF-5. http://www.uspreventiveservicestaskforce.org/draftresplan.htm