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Impact of variation in functions and delivery on the effectiveness of behavioural and mood management interventions for smoking cessation in people with depression: protocol for a systematic review and meta-analysis
  1. Gemma Taylor1,2,
  2. Paul Aveyard3,
  3. Regina Van der Meer4,5,
  4. Daniel Toze1,2,
  5. Bobby Stuijfzand6,
  6. David Kessler7,
  7. Marcus Munafò1,2
  1. 1 Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
  2. 2 UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
  3. 3 Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, Oxford, UK
  4. 4 Department of Epidemiology and Health Promotion, Public Health Service of Haaglanden (GGD Haaglanden), Hague, The Netherlands
  5. 5 CAPHRI, Maastricht University, Maastricht, The Netherlands
  6. 6 Jean Golding Institute for Data-Intensive Research, University of Bristol, Bristol, UK
  7. 7 Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
  1. Correspondence to Dr Gemma Taylor; gemma.taylor{at}


Introduction Tobacco is the world’s leading preventable cause of disease and death. People with depression are twice as likely to smoke and are less responsive to standard tobacco treatments as compared with the general population. A Cochrane systematic review of randomised controlled trials of smoking cessation treatment for smokers with current or historical depression found that adding mood management to usual smoking treatment improved quit rates. However, the review did not examine if variation in intervention delivery or intervention functions impacted on treatment effectiveness.

With the aim of providing information to develop tailored approaches to treating smoking for people with current depression, we will add-on to the Cochrane review in three ways: (1) use the Template for Intervention Description and Replication checklist to determine if variations in mood management delivery have impact on intervention effectiveness, (2) use the Taxonomy of Behaviour Change techniques for smoking cessation to examine which behaviour change functions are most effective for smoking cessation in people with current depression and (3) examine the difference in change in depression scores between intervention and control arms.

Methods and analysis We will include randomised controlled trials of smokers with current depression as identified by a previous Cochrane review and the in-progress update of this Cochrane review. We will use meta-regression to examine (1) if variations in delivery of mood management impact on smoking cessation intervention effectiveness, (2) determine which behaviour change functions are most effective for smoking cessation and (3) use meta-analysis of the difference in change in depression scores between treatment arms from baseline to follow-up to determine if offering smoking cessation treatment causes psychological harm.

Ethics and dissemination Ethical approval is not required for this study. We will disseminate the findings of this work at national and international conferences, and to relevant patient panels.

PROSPERO registration number CRD42017070741.

  • Tobacco
  • Smoking cessation
  • Depression
  • Systematic review
  • Protocol
  • Intervention

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  • Contributors All authors contributed to writing the manuscript and reviewed the final draft. GT, PA, RVM, DK, BS and MM all contributed towards study design. DT contributed towards writing the manuscript. GT and MM act as the guarantors of this review.

  • Funding GT is funded by Cancer Research UK Population Researcher Postdoctoral Fellowship award (reference: C56067/A21330). PA is supported by the NIHR Biomedical Research Centre and the NIHR CLAHRC. RVM reports no funding for this work. BS and DK are funded by The University of Bristol. MM would like to acknowledge funding from The MRC Integrative Epidemiology Unit at the University of Bristol which is supported by the Medical Research Council and the University of Bristol (MC_UU_12013/6). GT, MM and PA are members of the UK Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research: Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.

  • Disclaimer The funders have had no role in developing the protocol or study design.

  • Competing interests All authors completed ICMJE form for disclosure of potential conflicts of interest. GT, DT, RVM, DK and BS report no competing interests. PA reports non-financial support from GSK, outside the submitted work. MM reports grants from Pfizer, outside the submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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