Unlike nicotine replacement therapies, the EVP may offer an alternative for those finding it difficult to quit the behavioural and sensorial aspects of smoking.
A Cochrane review on the effect of behavioural support in combination with pharmacotherapy [ 9] found, on pooling 38 studies most of which offered 4 or more sessions, that there was a small but statistically significant positive effect of increased attendance of the behavioural therapy, be it face-to-face or by phone, on long-term quitting behaviour.
Nevertheless, absolute long-term quit rates with NRT are low: typically, fewer than 20% of people quitting with NRT plus behavioural support are still abstinent at 12 months [ 3].
However, there are other proven effective treatments: 1) brief clinical interventions (i.e. when a doctor takes 10 minnutes or less to deliver advice and assistance about quitting), 2) counselling, 3) behavioural cessation therapies, 4) treatments with more person-to-person contact and intensity, and 5) cessation medications found to be effective for treating tobacco dependence.
Current U.S. Clinical Practice Guidelines recommend that all smokers be advised to use medication and behavioural treatment in quitting [ 23].
9 Nevertheless, as for self-report research, future fMRI research is needed to determine whether neural responses predict meaningful behavioural change (ie, quitting smoking) or perceptual change (eg, better understanding of risks, particularly among youth).
Nevertheless, care must be taken in stating the effects of making lifestyle or behavioural changes, such as quitting smoking, reducing alcohol intake or finding full-time employment.
An array of behavioural directives, such as quitting smoking, increasing exercise, normalising weight, and adhering to monitoring, dietary and medication prescriptions is imposed on patients with type 2 diabetes.
Additionally, the range of available behavioural and pharmacological support options for quitting smoking needs to be made apparent to clients and integrated into a clear clinical pathway.
The highest cessation rate was among those who used prescription medication and behavioural counselling (20.4%) followed by those who used NRT and behavioural counselling (17.4%), attempted to quit unassisted (16.4%), used behavioural counselling only (16.1%) and those who used prescription medication only (15.3%).
