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KMID : 1231220210120010008
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Journal of the Korean Society for Research on Nicotine and Tobacco
2021 Volume.12 No. 1 p.8 ~ p.15
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Behavioral Therapy and Pharmacotherapy for Relapse Prevention in Abstinent Smokers: Korea Preventive Services Task Force Guidance
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Lee Na-Ae
Lee Eon-Sook
Yun Jae-Moon
Lee Cheol-Min
Oh Seung-Won
Choi Young-Lee
Cho Be-Long
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Abstract
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Background: This paper presents the Korea Preventive Services Task Force (KPSTF) guidance on behavioral and pharmacotherapy for relapse prevention in abstinent smokers.
Methods: Evidence was evaluated at the evidence-based practice center of the KPSTF to develop KPSTF guidance through a rapid systematic review of both behavioral and pharmacologic intervention. Subsequently, evidence level and recommendation grade were examined in accordance with the KPSTF Manual for Public Health Guidance. Consensus on the recommendation grade determined by nine experts was obtained using a modified Delphi method to evaluate the effect size, priority, resources, feasibility, health equity, and reliability of the values and preferences.
Results: This guidance applies to smokers who successfully quit smoking over 24 h on their own (unassisted abstainers), who forcibly quit because of pregnancy or hospitalization, or who quit by participating in a smoking cessation program (assisted abstainers).
Conclusion: The KPSTF does not recommend providing behavioral therapy for abstinent smokers for relapse prevention (Recommendation grade: D, evidence level: high). Instead, it recommends pharmacotherapy, albeit with weak intensity (Recommendation grade: B evidence level: high). A significant effect was confirmed in the relapse prevention intervention in pharmacotherapy, but the effect was not large (RR [95% CI]: 1.15 [1.05, 1.26], I2=40.71%).
This recommendation was developed on the basis of diverse drug and foreign data, so evidence should be obtained through randomized clinical trials. However, we cannot conclude if it will have the same effect in Korea. Therefore, a sufficient number of domestic studies and long-term follow-up are required in the future to verify the relapse prevention intervention.
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KEYWORD
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Behavioral therapy, Pharmacotherapy, Relapse prevention, Smoking cessation, Guidance
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