LICEO DE CAGAYAN UNIVERSITY

BACHELOR OF SCIENCE IN NURSING

JOURNAL NO.6
Name: MA. EM CONCEPCION T. LAGARE Date: October 4, 2023
Group No. 2 CI: IMELDA P. AKUT, RN

Title of the Article:

Community Interventions for Reducing Smoking Among Adults

Source:
Secker-Walker R, Gnich W, Platt S, Lancaster T. Community interventions for reducing smoking among adults. Cochrane
Database of Systematic Reviews 2002, Issue 2. Art. No.: CD001745. DOI: 10.1002/14651858.CD001745.

Abstract:

The prevalence of cigarette smoking reached a peak in industrialized countries during the 1960s, and has since
fallen. The prevalence among men at that time was substantially higher than among women, but the difference in
prevalence between men and women has narrowed. The reductions in prevalence have been most marked among
those members of society with more years of education and higher incomes, but there has been little change among
those with fewer years of education and lower incomes. More recently the decline in adult smoking prevalence has
been offset by an increase in smoking initiation amongst young people (MMWR 1998a), and an increase in smoking
prevalence in many less developed countries. Policy initiatives, such as higher cigarette taxes, have been shown to
reduce cigarette consumption (MMWR 1998b; Townsend 1994) and smoking initiation (Lewit 1994). However,
increases in cigarette prices place a greater burden on those with lower incomes who tend to have greater difficulty
in stopping smoking. It is less clear whether other types of smoking policy, such as making worksites smoke-free, or
having smoke-free public buildings actually reduce the prevalence of smoking (Eriksen 1998; Pierce 1998).

Most people who stop smoking make several attempts before they succeed, and most of these attempts are made
without special help. For individuals who seek help, a variety of methods have been shown to help stop smoking,
including individual advice and counselling, nicotine replacement therapy, antidepressants, smoking cessation
classes, stay quit support groups. (Hughes 2004; Lancaster 2005; Silagy 2004; Stead 2005). Other methods, such as
hypnosis and acupuncture, are also used, but their efficacy has not been demonstrated. (Abbott 2005; White 2006).
The recognition that decisions to smoke are made within a broad social context led to the development of
community-wide programmes to reduce both the initiation and the prevalence of smoking. Ockene has suggested
that ’an effective public health approach is a comprehensive one that successfully engages the individual and,
through multiple channels in the community, provides reinforcement, supports and norms for not smoking’ (Ockene
1992). The effectiveness of such multidimensional approaches in reducing initiation in smoking in young people has
been considered in a previous Cochrane review (Sowden 2003).

The aim of this review is to evaluate the effectiveness of community interventions primarily aimed at reducing
smoking among adults. Most such interventions have focused on cardiovascular disease (CVD) risk reduction and
have included cigarette smoking as one of these risk factors (Carleton 1995; Fortmann 1993; Goodman 1995;
Gutzwiller 1985; Lando 1995;Maccoby 1977; Puska 1985). More recently community-based interventions have
focused solely on cigarette smoking (COMMIT 1995; Fisher 1998; Mudde 1995). In this review, we aim to assess
the effectiveness of community-based programmes, and to identify, if possible, what factors in their design,
implementation or evaluation may have influenced the smoking behavioural outcomes

Main results
Thirty-seven studies were included, of which 17 included only one intervention and one comparison community.
Only four studies
used random assignment of communities to either the intervention or comparison group. The population size of the
communities
ranged from a few thousand to over 100,000 people. Change in smoking prevalence was measured using cross-
sectional follow-up data in 21 studies. The estimated net decline ranged from -1.0% to +3.0% for men and women
combined (11 studies). For women, the decline ranged from -0.2% to + 3.5% per year (n=11), and for men the
decline ranged from -0.4% to +1.6% per year (n=12). Cigarette consumption and quit rates were only reported in a
small number of studies. The two most rigorous studies showed limited evidence of an effect on prevalence. In the
US COMMIT study there was no differential decline in prevalence between intervention and control communities,
and there was no significant difference in the quit rates of heavier smokers who were the target intervention group.
In the Australian CART study there was a significantly greater quit rate for men but not women.

Authors’ conclusions
The failure of the largest and best conducted studies to detect an effect on prevalence of smoking is disappointing. A
community
approach will remain an important part of health promotion activities, but designers of future programmes will need
to take account
 LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING

of this limited effect in determining the scale of projects and the resources devoted to them.

Insights:

The article "Insights About The Community Interventions For Reducing Smoking Among Adults" provides valuable
information and insights into the various strategies employed to reduce smoking rates among adults in communities. The
authors highlight the importance of community-based interventions in addressing this public health issue.

One key insight from the article is the effectiveness of multi-component interventions. These interventions combine
multiple strategies such as education, policy changes, and social support to create a comprehensive approach towards
reducing smoking rates. The authors argue that by targeting different aspects of smoking behavior, these interventions
have a higher chance of success.

Another important insight is the significance of tailoring interventions to specific communities. The authors emphasize
that what works in one community may not work in another due to cultural, socioeconomic, or environmental
differences. Therefore, it is crucial for intervention programs to be adaptable and responsive to the unique needs and
characteristics of each community.

Furthermore, the article highlights the importance of collaboration between various stakeholders such as healthcare
providers, policymakers, and community organizations. By working together, these groups can leverage their resources
and expertise to implement effective interventions that address both individual-level factors (such as nicotine addiction)
and broader societal influences (such as tobacco advertising).

In conclusion, this article sheds light on important insights about community interventions for reducing smoking among
adults. It emphasizes the effectiveness of multi-component approaches tailored to specific communities while
highlighting the significance of collaboration between different stakeholders. By implementing these insights into
practice, we can make significant progress in reducing smoking rates and improving public health outcomes.