Smoking-cessation interventions for U.S. young adults: a systematic review

Context: Studies have demonstrated the importance of quitting smoking before age 30 years to avoid tobacco-related mortality but little attention has been paid to developing evidence-based smoking-cessation interventions for young adults, as distinct from adolescents and older-aged adults. The objective of this study was to conduct a systematic review of smoking-cessation interventions for U.S. young adults (aged 18-24 years).

Evidence acquisition: Electronic searches were conducted in CINAHL, the Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Sociological Abstracts to identify eligible interventions through August 31, 2009. Two independent coders critically evaluated the methodology and findings of all retrieved articles. Data analysis was conducted in 2010.

Evidence synthesis: Twelve RCTs and two nonrandomized studies met the inclusion criteria; these studies varied with respect to sample size, intervention, outcomes assessed, and smoking measures. Pooled results for two studies based on social cognitive theory indicated that they were effective in promoting short-term abstinence at 1-3-month follow-up and 4-6-month follow-up. Four studies had a significant positive impact on smoking cessation: two in the short term and two at 6 months or more.

Conclusions: There is limited evidence demonstrating efficacy of smoking-cessation interventions for U.S. young adults. There were no pharmacologic interventions included in this review. Promising interventions were brief, with extended support via telephone and electronic media. Further high-quality studies using standardized smoking measures and additional studies outside the college setting are needed to identify and tailor effective smoking-cessation interventions for at-risk young adults in the U.S.