Effectiveness of community health workers involvement in smoking cessation programme: A systematic review.

Siti Hafizah Zulkiply,Lina Farhana Ramli,Bushra Tabassum,Zul Aizat Mohamad Fisal,Rosliza Abdul Manaf,Stanton A Glantz

doi:10.1371/journal.pone.0242691

Abstract

Sustainable Development Goals (SDG) has set the target to reduce premature mortalities from non-communicable diseases (NCDs) by one-third. One of the ways to achieve this is through strengthening the countries' implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Community health workers (CHWs) involvement has shown promising results in the prevention of NCDs. This systematic review is aimed at critically evaluating the available evidence on the effectiveness of involving CHWs in smoking cessation. We systemically searched PubMed and CENTRAL up to September 2019. We searched for published interventional studies on smoking cessation interventions using the usual care that complemented with CHWs as compared to the usual or standard care alone. Our primary outcome was abstinence of smoking. Two reviewers independently extracted data and assessed study risks of bias. We identified 2794 articles, of which only five studies were included. A total of 3513 smokers with 41 CHWs were included in the studies. The intervention duration range from 6 weeks to 30 months. The studies used behavioral intervention or a combination of behavioral intervention and pharmacological treatment. Overall, the smoking cessation intervention that incorporated involvement of CHWs had higher smoking cessation rates [OR 1.95, 95% CI (1.35, 2.83)]. Significant smoking cessation rates were seen in two studies. Higher smoking cessation rates were seen in the interventions that combined the usual care with interventions by CHWs as compared to the usual care alone. However, there were insufficient studies to prove the effectiveness. In addition, there was high heterogeneity in terms of interventions and participants in the current studies.

Highlights

Non-communicable diseases (NCD) are the major cause of mortalities worldwide
This systematic review is aimed at critically evaluating the available evidence on the effectiveness of involving Community health workers (CHWs) in smoking cessation
We searched for published interventional studies on smoking cessation interventions using the usual care that complemented with CHWs as compared to the usual or standard care alone

Summary

Introduction

Non-communicable diseases (NCD) are the major cause of mortalities worldwide. Smoking is an important risk factor for the development of NCD, including cancers, and cardiovascular and respiratory diseases [1]. SDG 3, with the goal to “ensure healthy lives and promote well-being for all ages” includes target 3.4, which is to reduce premature mortality from NCD by one-third, and target 3a, which is to strengthen a country’s implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) [2,3]. The World Health Organization (WHO) has developed MPOWER that include measures for demand reduction: i) Monitoring tobacco use and prevention policies; ii) Protecting people from tobacco smoke; iii) Offering help to quit tobacco use; iv) Warning about the dangers of tobacco; v) Enforcing bans on tobacco advertising, promotion and sponsorship; and vi) Raising taxes on tobacco [5]. Sustainable Development Goals (SDG) has set the target to reduce premature mortalities from non-communicable diseases (NCDs) by one-third. One of the ways to achieve this is through strengthening the countries’ implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). This systematic review is aimed at critically evaluating the available evidence on the effectiveness of involving CHWs in smoking cessation

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