Smoking cessation for improving mental health

Gemma Taylor, Nicola Lindson, Amanda Farley, Andrea Leinberger-Jabari, Katherine Sawyer, Rebecca te Water Naudé, Annika Theodoulou, Naomi King, Chloe Burke, Paul Aveyard

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Abstract

Background
There is a common perception that smoking generally helps people to manage stress, and may be a form of 'self‐medication' in people with mental health conditions. However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine withdrawal symptoms (e.g. anxiety, depression, irritability), in which case smoking cessation may help to improve rather than worsen mental health.

Objectives
To examine the association between tobacco smoking cessation and change in mental health.

Search methods
We searched the Cochrane Tobacco Addiction Group's Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and the trial registries clinicaltrials.gov and the International Clinical Trials Registry Platform, from 14 April 2012 to 07 January 2020. These were updated searches of a previously‐conducted non‐Cochrane review where searches were conducted from database inception to 13 April 2012.

Selection criteria
We included controlled before‐after studies, including randomised controlled trials (RCTs) analysed by smoking status at follow‐up, and longitudinal cohort studies. In order to be eligible for inclusion studies had to recruit adults who smoked tobacco, and assess whether they quit or continued smoking during the study. They also had to measure a mental health outcome at baseline and at least six weeks later.

Data collection and analysis
We followed standard Cochrane methods for screening and data extraction. Our primary outcomes were change in depression symptoms, anxiety symptoms or mixed anxiety and depression symptoms between baseline and follow‐up. Secondary outcomes included change in symptoms of stress, psychological quality of life, positive affect, and social impact or social quality of life, as well as new incidence of depression, anxiety, or mixed anxiety and depression disorders.

We assessed the risk of bias for the primary outcomes using a modified ROBINS‐I tool. For change in mental health outcomes, we calculated the pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) for the difference in change in mental health from baseline to follow‐up between those who had quit smoking and those who had continued to smoke. For the incidence of psychological disorders, we calculated odds ratios (ORs) and 95% CIs. For all meta‐analyses we used a generic inverse variance random‐effects model and quantified statistical heterogeneity using I2. We conducted subgroup analyses to investigate any differences in associations between sub‐populations, i.e. unselected people with mental illness, people with physical chronic diseases.

We assessed the certainty of evidence for our primary outcomes (depression, anxiety, and mixed depression and anxiety) and our secondary social impact outcome using the eight GRADE considerations relevant to non‐randomised studies (risk of bias, inconsistency, imprecision, indirectness, publication bias, magnitude of the effect, the influence of all plausible residual confounding, the presence of a dose‐response gradient).

Main results
We included 102 studies representing over 169,500 participants. Sixty‐two of these were identified in the updated search for this review and 40 were included in the original version of the review. Sixty‐three studies provided data on change in mental health, 10 were included in meta‐analyses of incidence of mental health disorders, and 31 were synthesised narratively.

For all primary outcomes, smoking cessation was associated with an improvement in mental health symptoms compared with continuing to smoke: anxiety symptoms (SMD −0.28, 95% CI −0.43 to −0.13; 15 studies, 3141 participants; I2 = 69%; low‐certainty evidence); depression symptoms: (SMD −0.30, 95% CI −0.39 to −0.21; 34 studies, 7156 participants; I2 = 69%' very low‐certainty evidence); mixed anxiety and depression symptoms (SMD −0.31, 95% CI −0.40 to −0.22; 8 studies, 2829 participants; I2 = 0%; moderate certainty evidence). These findings were robust to preplanned sensitivity analyses, and subgroup analysis generally did not produce evidence of differences in the effect size among subpopulations or based on methodological characteristics. All studies were deemed to be at serious risk of bias due to possible time‐varying confounding, and three studies measuring depression symptoms were judged to be at critical risk of bias overall. There was also some evidence of funnel plot asymmetry. For these reasons, we rated our certainty in the estimates for anxiety as low, for depression as very low, and for mixed anxiety and depression as moderate.

For the secondary outcomes, smoking cessation was associated with an improvement in symptoms of stress (SMD −0.19, 95% CI −0.34 to −0.04; 4 studies, 1792 participants; I2 = 50%), positive affect (SMD 0.22, 95% CI 0.11 to 0.33; 13 studies, 4880 participants; I2 = 75%), and psychological quality of life (SMD 0.11, 95% CI 0.06 to 0.16; 19 studies, 18,034 participants; I2 = 42%). There was also evidence that smoking cessation was not associated with a reduction in social quality of life, with the confidence interval incorporating the possibility of a small improvement (SMD 0.03, 95% CI 0.00 to 0.06; 9 studies, 14,673 participants; I2 = 0%). The incidence of new mixed anxiety and depression was lower in people who stopped smoking compared with those who continued (OR 0.76, 95% CI 0.66 to 0.86; 3 studies, 8685 participants; I2 = 57%), as was the incidence of anxiety disorder (OR 0.61, 95% CI 0.34 to 1.12; 2 studies, 2293 participants; I2 = 46%). We deemed it inappropriate to present a pooled estimate for the incidence of new cases of clinical depression, as there was high statistical heterogeneity (I2 = 87%).

Authors' conclusions
Taken together, these data provide evidence that mental health does not worsen as a result of quitting smoking, and very low‐ to moderate‐certainty evidence that smoking cessation is associated with small to moderate improvements in mental health. These improvements are seen in both unselected samples and in subpopulations, including people diagnosed with mental health conditions. Additional studies that use more advanced methods to overcome time‐varying confounding would strengthen the evidence in this area.
Original languageEnglish
Article numberCD013522
Pages (from-to)1-240
Number of pages240
JournalCochrane Database of Systematic Reviews
Volume2021
Issue number3
DOIs
Publication statusPublished - 9 Mar 2021

Bibliographical note

Funding Information:
Supported by the Spanish Ministry of Economy and Competiveness (Project reference: PSI2015-66755-R) and co-financed by FEDER (European Regional Development Fund; pluri-annual plan 2014-2020)

Funding Information:
Funded by a National Institute of Mental Health grant awarded to Drs. Michael J. Zvolensky and Norman B. Schmidt (R01-MH076629-01A1). Ms. Farris is supported by a pre-doctoral National Research Service Award from the National Institute of Drug Abuse (F31-DA035564)

Funding Information:
Supported by the National Institute on Drug Abuse (grant number K23 DA019950) awarded to Ana M. Abrantes, PhD

Funding Information:
Dr Cinciripini served on the scientific advisory board of Pfizer, conducted educational talks sponsored by Pfizer on smoking cessation (2006-2008), and has received grant support from Pfizer

Funding Information:
This research was supported by grants from the National Institute on Drug Abuse (R01DA025078 and R01DA033681) and from the National Cancer Institute (R01CA165001 and P50CA143187) Dr.Schnoll and Dr. Hitsman receive medication and placebo free of charge from Pfizer and have provided consultation to Pfizer; Dr.Schnoll has also consulted with GlaxoSmithKline; these companies had no involvement in this study

Funding Information:
This study was supported by the Health Promotion Administration, Ministry of Health and Welfare, Taiwan (No. 95039-1)

Funding Information:
The Northwest Network Mental Illness Research, Education and Clinical Center, the Center for Excellence in Substance Abuse Treatment and Education, and a grant from the University of Washington Alcohol and Drug Abuse Institute

Funding Information:
The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (ZonMw, grant number 10-000-1001) and matching funds from participating pharmaceutical companies (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag) and universities and mental health-care organisations (Academic Psychiatric Center of Amsterdam UMC, Meibergdreef, and the mental health institutions GGZ inGeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Center, GGZ Noord Holland Noord; University Medical Center Groningen, and the mental health institutions Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht, and Parnassia psycho-medical center, The Hague; Maastricht University Medical Center and the mental health institutions GGzE, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezond-heid, Mondriaan, Virenze riagg, Zuyderland GGZ, MET ggz, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem; University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Cen-traal, and Delta) WvdB received speakers’ fees from Lundbeck, Indivior, Eli Lilly, and Pfizer and he is a consultant to Indi-vior, Mundipharma, Novartis, Bioproject, D&A Pharmaceuticals, and Opiant Pharmaceuticals. All other authors declare no competing interests

Funding Information:
Supported by the Scientific and Technological Foundation Projects of Shanghai Jiao Tong University, School of Medicine (No.13XJ10050); the Shanghai Ninth People’s Hospital Foundation (No.2013A10)

Funding Information:
Outcome measure(s): Smoking Cessation Quality of Life (SCQoL) questionnaire, a validated instrument composed of the SF-36 (Version 1) as the generic core and 5 additional smoking-related domains This work was supported by Pfizer Inc which was the sponsor and funding source for both clinical trials reported here (NCT Identifier: NCT00143364 and NCT00141206.

Funding Information:
Name: Johannes Kornhuber, Address: Schwabachanlage 6 91054 Erlangen Germany, Telephone: +49 9131 85 34166, Email: johannes.kornhuber@uk-erlangen.de, Affiliation: Universitätsklinikum Erlangen, Psychiatrische und Psychotherapeutische Klinik Registry ID: DRKS00014920 Funding source: With the public funded research project IMAC-Mind: Improving Mental Health and Reducing Addiction in Childhood and Adolescence through Mindfulness: Mechanisms, Prevention and Treatment (2018–2022, 01GL1745C), the Federal Ministry of Education and Research contributes to improving the prevention and treatment of children and adolescents with substance use disorders and associated mental disorders. The project coordination is realised by the German Center of Addiction Research in Childhood and Adolescence at the University Medical Center Hamburg-Eppendorf. For more information please visit our homepage www.IMAC-Mind.de Declaration of interests: The authors quote some of their own publications on which this work and the idea of the study are based

Funding Information:
Supported by PHS grants HL56626 and HL68569

Funding Information:
NIH grant R01 HL-062165 to Belinda Borrelli National Institute of Health

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This material is based upon work supported by the Department of Veterans

Funding Information:
There was no financial support for this study and there was no support from any pharmaceutical company for any aspect of this research. none for study. the UMDNJ-Tobacco Dependence Clinic is funded through a grant from the New Jersey Department of Health and Senior Services – Comprehensive Tobacco Control Program

Funding Information:
This study has been funded by AstraZeneca

Funding Information:
Affairs, Veterans Health Administration, Office of Research and Development, and Health Services Research and Development, grant #SDP 07-034

Funding Information:
This research was supported by the Spanish Ministerio de Ciencia y Competi-tividad (Project reference: PSI2012-31196) and by FEDER (European Regional Development Fund)

Funding Information:
PA is funded by the NIHR Oxford Biomedical Research Centre

Funding Information:
This research was supported by National Institute of Health (NIH) Research Awards R01DA014028 and R01HD075669, Institutional Training Grant T32DA007242, Tobacco Centers of Regulatory Science Award P50DA036114, and Centers of Biomedical Research Excellence Center Award P20GM103644

Funding Information:
This work was primarily supported by award number 1IK2CX000718 to Dr. Dedert from the CSR&D Service of the VA Office of Research and Development

Funding Information:
The UK Medical Research Council, the Wellcome Trust, and the University of Bristol provided core support for this cohort study

Funding Information:
Registry ID: ClinicalTrials.gov, NCT01065506 Funding source: The study is funded by the National Institute of Drug Abuse (NIDA; R01DA027533) Declaration of interests: Drs Smits and Otto receive royalties from Oxford University Press for books on exercise for mood and anxiety disorders. All other authors declare that they have no competing interests

Funding Information:
This study was funded as part of a grant from the Medical Research Council, UK: G0500274

Funding Information:
Correspondence: kathleen.garrison@yale.edu 1 Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA 4 1 Church Street, Room 730, New Haven CT 06510, USA Registry ID: Clinicaltrials.gov NCT02134509 Funding source: This research is funded by a grant from the American Heart Association (to KAG: 14CRP18200010). Additional research support is provided by a grant from the National Institutes of Health, National Institute on Drug Abuse (to KAG and JAB: K12DA00167) Declaration of interests: Judson A. Brewer and Prasanta Pal own stock in Claritas Mindsciences, the company that developed the apps used in this study. All other authors declare that they have no competing interests

Funding Information:
This work was funded by the National Institute of Health - R01 DA021245 (Evins) and K24 DA030443 (Evins) Dr. Evins, within the past 5 years has received research study support to her institution from Pfizer, Forum Pharmaceuticals, GlaxoSmithKline (GSK), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), and Patient-Centered Outcomes Research Institute (PCORI) and has provided consulting and/or advisory board services to Pfizer and Reckitt Benckiser. Dr. Achtyes has received research grant support from AssurEx, Janssen, Michigan State University, Pine Rest Foundation,

Funding Information:
This work was supported by the National Heart Lung and Blood Institute (R01-HL111821)

Funding Information:
lence. 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. Dr. Kate Bartlem is funded by a National Health and Medical Research Council Early Career Fellowship (#1142272). Professor Chris Metcalfe is funded by the Higher Education Funding Council for England) Declaration of interests: Drs. Ali Shaw, David Kessler and Kate Bartlem have no conflicts of interest. Professor Chris Metcalfe has no conflicts of interest. Dr Gemma Taylor and Professor Marcus Munafò have received funding from Pfizer, who manufacture smoking cessation products Professor Paul Aveyard led a trial funded by the NIHR and Glaxo SmithKline donated nicotine patches to the NHS in support of the trial

Funding Information:
Study was supported by master and doctoral research training scholarships from the Fonds pour la recherche en santédu Québec and a scholarship from the Psychosocial Oncology ResearchTraining program of the Canadian Institutes of Health Research and a grant from the CanadianInstitutes of HealthResearch (MOP-69073)

Funding Information:
Preparation of the article was supported by National Institute of Mental Health Research Scientist Development Award K02 MH00721 to Sheldon Cohen; research in this article was supported by National Cancer Institute Grant CA38243 to Sheldon Cohen and Edward Lichtenstein

Funding Information:
Study was supported by the Swedish Research Council (Vetenskapsrädet) (grant number K2008-70X01-3), the Swedish Research Council Linnaeus Centre for Economic Demography (grant number VR 79) and the Research Funds of Malmo University Hospital

Funding Information:
This project was supported by a grant from the National Institutes of Health (U01DA20830) and by MD Anderson's Cancer Center Support Grant (P30CA016672); Pfizer provided varenicline and placebo pills at no cost Caryn Lerman received study medication and support for medication packaging from Pfizer; she has also consulted to Gilead, and has been a paid expert witness in litigation against tobacco companies. Rachel Tyndale has acted as a consultant to Apotex and to Quinn Emmanuel. Paul Cinciripini served on the scientific advisory board of Pfizer Pharmaceuticals, did educational talks sponsored by Pfizer on smoking cessation from 2006 to 2008, and has received grant and medication support from Pfizer. Dr. Schnoll receives medication and placebo free of charge from Pfizer for other clinical trials and has provided consultation to Pfizer and GlaxoSmithKline. Dr. Benowitz has been a consultant to pharmaceutical companies that market smoking cessation medications, including Pfizer, and has served as an expert witness in litigation against tobacco companies. Dr. Hawk receives medication and placebo free of charge from Pfizer for an ongoing clinical trial. The remaining authors declare no competing interests

Funding Information:
The ITC Four-Country Survey is supported by multiple grants, including R01 CA 100362 and P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center) and also in part from grant P01 CA138389 (Roswell Park Cancer Institute, Buffalo, New York), all funded by the National Cancer Institute of the United States, Robert Wood Johnson Foundation (045734), Canadian Institutes of Health Research (57897, 79551), National Health and Medical Research Council of Australia (265903, 450110, APP1005922), Cancer Research UK (C312/A3726), Canadian Tobacco Control Research Initiative (014578); and the Centre for Behavioural Research and Program Evaluation, National Cancer Institute of Canada/Canadian Cancer Society

Funding Information:
This research was supported by the Spanish Ministry of Science and Innovation Grants (PSI2011-22804 and PSI2011-23395) and by the Pre-doctoral Grants BP12-037, from the Foundation for the Promotion of Applied Scientific Research and Technology in Asturias and BES-2012-053988, from the Spanish Ministry of Economy and Competitiveness

Funding Information:
Outcome measure(s): Positive and Negative Affect Scale (PANAS); Quality of Life Inventory (QOLI; friendships subscale) This research was supported by grants P50DA019706, K08DA021311, K08DA02504, and 1K05CA139871 from National Institutes of Health (NIH), 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources (NCRR), and an Institutional Clinical and Translational Science Award (UW-Madison; KL2 Grant # 1KL2RR025012-01). GlaxoSmithKline provided medication to patients at no cost. Additional funding source in Piper 2012/2013: grant no. M01 RR03186 from the General Clinical Research Centers Program of the National Center for Research Resources, NIH Not reported in Leventhal 2014 but in Piper 2013: Megan E. Piper, Matthew Rodock, Jessica W. Cook, Tanya R. Schlam and Timothy B. Baker have no potential conflicts of interest to disclose. Over the last 3 years, Michael C. Fiore served as an investigator on research studies at the University of Wisconsin that were funded in part by NabiBiopharmaceuticals. From 1998 to 2010, Dr. Fiore held a University of Wisconsin named Chair, made possible by a giJ from GlaxoWellcome

Funding Information:
Public Health Service grant 05-15-D67 (a Cancer demonstration grant) from the National Center for Chronic Disease Control

Funding Information:
Funded by grants DA-04066,DA-03728, and DA-0298, Research Scientist Development Award DA-00109 (Dr Hughes) from the National Institute on Drug Abuse, and grant HL-39220 from the National Heart, Lung, and Blood Institute, Bethesda, Md

Funding Information:
Secondary analysis partially funded by investigator-initiated research agreement awarded by Pfizer Ltd to the Research Foundation for Mental Hygiene (Principle Investigator: Lirio Covey) I. Berlin reports having received occasional honoraria for participating in advisory panels of Sanofi-Aventis and Pfizer Ltd during the last 3 years. Lirio S. Covey received research support from Pfizer, Inc. None of the authors have any connection with tobacco, alcohol or gaming industries

Funding Information:
This study was funded by a grant from the National Center for Complementary and Alternative Medicine (NCCAM) to Dr. Bock (AT003669)

Funding Information:
Funding was provided by the Cooperative Studies Program of the Clinical Science Research and Development Service, U.S. Department of Veterans Affairs (DVA; CSP #519, NCT00118534) and the Tobacco-Related Disease Research Program 19DT-0003. Dr. Baker receives research support from the Department of Defense (Navy BUMED and CDMRP PTO 090738) and the DVA (HSR&D SDR09-128) and is supported in part by the VA Center of Excellence for Stress and Mental Health. Dr. McFall receives research support from VA Merit #821 and DVA. Dr. Saxon receives research support from NIAAA (1 P20 AA017839-01), NIDA (5 U10 DA013714-08), and from VA HSR&D (1 IO1 HX000616-01)

Funding Information:
Financial support for the present study was provided entirely by a grant from the Netherlands Heart Foundation (2000/B216)

Funding Information:
This work was supported the National Institute of Mental Health (R01 MH076776-03 to JAB), National Cancer Institute (R25T CA057730 to ARM; S. Chang, Principal Investigator), and National Institutes of Health (P30 CA016672 to the University of Texas MD Anderson Cancer Center)

Funding Information:
Supported by the National Cancer Institute R03 CA 126409 and in part by the Biostatistics Core Facility at the H. Lee Moffitt Cancer Center & Research Institute, an NCI designated Comprehensive Cancer Center (P30-CA76292)

Funding Information:
CR, DL, LSA, and TM are employees and stockholders of Pfizer. AK is a PAREXEL employee working on behalf of GlaxoSmithKline. AEE reports research grants to her institution from Forum Pharmaceuticals and Pfizer and personal fees for advisory board services from Pfizer and Reckitt Benckiser. RW is a consultant to Pfizer, Johnson & Johnson, and GlaxoSmithKline and has received research funding from Pfizer and Johnson & Johnson; RW's salary is funded by Cancer Research UK. RMA reports his university receiving grants from Alkermes and Pfizer and providing consulting and/or advisory board services to Arena Pharmaceuticals, Cerecor, Pfizer, and US WorldMeds

Funding Information:
Support for this research was provided by grant DA017073 from the National Institute on Drug Abuse (Dr Cinciripini) and by Cancer Center Support Grant P50CA70907 from the National Cancer Institute. Varenicline was provided by Pfizer

Funding Information:
The Patrick and Catherine Weldon Donaghue Foundation, The University of Connecticut Center on Aging, and NIH grants R01 DA13334, R01DA024872, and M01 RR06192 (University of Connecticut General Clinical Research Center) and P50AA15632. GlaxoSmithKline Pharmaceuticals donated nicotine and placebo patches

Funding Information:
This research was supported by the National Cancer Institute grant R01CA156241 to CWK

Funding Information:
This study was supported by NIHNIAAA R01-AA01718 (Kahler)

Funding Information:
Study was funded by ViiV healthcare Germany and GSK Austria

Funding Information:
National Institute on Drug Abuse (grants K23 DA018691, K05 DA016752, and P50 DA09253) and the, State of California Tobacco-Related Disease Research Program (grant 13KT–0152)

Funding Information:
This publication was made possible by grants from the National Center for Research Resources (NCRR; grants no. UL1 RR024992 and KL2 RR024994), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research and by grant no. K02DA021237 from the NIH. Other support includes an American Cancer Study (ACS) grant no. IRG-58-010-54, NIH Career Development Award (NIDA, no. K01DA025733) and an additional NIDA (no. R01 DA032843 awarded to P.A.C.-R.), and NIH Midcareer Investigator Awards to L.J.B. (K02 DA021237 awarded to L.J.B and no. R01 DA031288 awarded to R.A.G.)

Funding Information:
This research was supported by the National Agency of Research of the Spanish Ministry of Science, Innovation and Universities and the European Regional Development Fund MINECO/FED-ER(PSI2015-64371-P)and by two predoctoral grants from the National Agency of Research of the Spanish Ministry of Science, Innovation and Universities (BES-2016-076663/FPU15/04327)

Funding Information:
Date of first enrolment 10 December 2014, last enrolment 30 March 2016, date of last data collection 3 October 2016 Dr Toby Pavey. Address: School of Human Movement Studies, Blair Drive, The University of Queensland, St. Lucia Campus, Brisbane, Australia, QLD 4072 Country Australia. Phone: +61 7 3346 9898. Email: t.pavey@uq.edu.au Registry ID: ACTRN12614001255673 Funding source: This study is supported by a Heart Foundation of Australia Vanguard Grant (#100587). TP is supported by a National Health and Medical Research Council program grant (#569940) at The University of Queensland, School of Human Movement and Nutrition Sciences Declaration of interests: The authors declare that they have no competing interests

Funding Information:
All authors indicated current/previous status as consultant or contractor for companies involved in cessation pharmacotherapy (MS has conducted research funded by Pfizer; JF has previously worked for Pfizer, Novartis, GSK, Celtic Pharma; JW has conducted research supported by Pfizer and is consultant for Novartis and BeBetter Inc.)

Funding Information:
Study was funded by Pfizer. Dr. Anthenelli’s writing of this manuscript was funded, in part, by a Department of Veterans Affairs Merit Review award (NEUA-003-08S) and by a National Institute on Alcohol Abuse and Alcoholism grant (AA019720). Dr. Morris was supported, in part, by grants from the University of California, San Francisco, Smoking Cessation Leadership Center and Colorado Department of Public

Funding Information:
This ZESCA trial was funded by the Canadian Institutes of Health Research (Grant NCT64989) and the Heart and Stroke Foundation of Quebec

Funding Information:
The MIDUS study was supported by a grant from the National Institute on Aging (P01-AG020166) to conduct a longitudinal follow-up of the MIDUS (Midlife in the U.S.) investigation; the original study was supported by the John D. and Catherine T. MacArthur Foundation Research Network on Successful Midlife Development; this research was also supported by a grant from National Cancer Institute (P50-CA148596) to the Harvard Lung Cancer Disparities Center; the first author is supported by a post-doctoral fellowship at the Center on the Developing Child sponsored by the Robert Wood Johnson Foundation

Funding Information:
Outcome measure(s): Positive and Negative Affect Schedule (PANAS; negative and positive affect subscales) This research was supported by grants from the National Cancer Institute (R01 CA165001; R01 CA184211) and the National Institute on Drug Abuse (K24 DA045244). NCI and NIDA had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication Dr. Schnoll receives medication and placebo free from Pfizer; Dr. Schnoll has provided consultation to Pfizer and GlaxoSmithKline, and consults with Curaleaf; all other authors declare that they have no conflicts of interest

Funding Information:
Registry ID: Clinicaltrials.gov NCT01928758 Funding source: National Institute on Drug Abuse of the National Institutes of Health under Award Number P50DA036107 (JM & JF PIs for parent grant; JF and AEE PIs for this study) and the Center for Tobacco Products of the U.S. Food and Drug Administration. NIH NIDA (P50DA036107), NCATS (UL1 TR000127), FDA Declaration of interests: JF has done paid consulting for pharmaceutical companies involved in producing smoking cessation medications, including GSK, Pfizer, Novartis, J&J, and Cypress Bioscience, and received a research grant from Pfizer Inc. (not related to reduced nicotine cigarettes). There are no competing interests to declare for other authors

Funding Information:
Primarily funded by the Victorian Centre of Excellence in Depression and Related Disorders an (initiative between beyond-blue and the State Government of Victoria, with contribution from Quit Victoria Ainslie Hannan and Ian Ferretter are employed by Quit Victoria. Together with Catherine Segan, Kay Wilhelm and Sunil Bhar, they developed and implemented Quit Victoria’s tailored service for depression-history smokers evaluated in this study. Ron Borland is employed by The Cancer Council Victoria, which houses Victoria’s Quitline. He has conducted research on the Quitline and has an ongoing interest in helping them improve the quality of their services

Funding Information:
Funding for this work was received from the Australian National Health and Medical Research Council (NHMRC project Grantnumber: 569210) and the Commonwealth Department of Health and Ageing. The Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Australia provided financial assistance for statistical analysis. Nicotine Replacement Therapy (NRT) was provided free to the study by GlaxoSmithKline (GSK) The authors report no financial partnership or speaking engagements with GSK, and GSK was not involved in any other aspect of the study design or analysis. None of the authors have any conflicts of interest to declare

Funding Information:
Dr. Lee has received research grants from the National Research Foundation of Korea (NRF) (2014002505)

Funding Information:
Name: Dr Gemma Taylor. Email: g.m.j.taylor@bath.ac.uk. Address: Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, 10 West, Bath BA2 7AY, UK Registry ID: World Health Organization's International Clinical Trials Registry Platform ID: ISRCT-N99531779/ Protocol reference: Pilot and Feasibility Studies 2019, 5:16 Funding source: The study is funded by Cancer Research UK. (Dr. Gemma Taylor is funded by a Cancer Research UK Postdoctoral Fellowship (C56067/A21330). Dr. Ali Shaw is funded through NIHR Research Capability Funding. The MRC Integrative Epidemiology Unit at the University of Bristol is supported by the Medical Research Council and the University of Bristol [MC_UU_12013/6]. Dr. David Kessler is funded by The Centre for Primary Care at the University of Bristol. Professor Paul Aveyard is an NIHR senior investigator and is funded by NIHR Oxford Biomedical Research Centre and CLAHRC. Dr. Gemma Taylor,and Professors Marcus Munafò and Paul Aveyard are members of the UK Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research: Centre of Excel-

Funding Information:
This study was supported by grants from the National Heart Foundation (Grant GOOH0578 and Fel-lowshipPH11H6047 to S.L.G.); the National Health and Medical Research Council (Grants 211316 and 544923 and fellowship APP1008299 to A.J.V.); the Tasmania Graduate Research Scholarship (to J.T.); the Tasmanian Community Fund (Grant D0013808); and Veolia Environmental Services (Sydney, New South Wales, Australia). The study was sponsored by Sanitarium Health and Wellbeing Australia (Melbourne, Victoria, Australia), ASICS Ltd. (Kobe, Japan) and Target Australia Pty. Ltd. (North Geelong, Victoria, Australia)

Funding Information:
Outcome measure(s): State-Trait Anxiety Inventory (STAI), Center for Epidemiologic Studies Depression Scale (CES-D) This work was supported by grant R21 DA023362 from the National Institutes of Health/National Institute on Drug Abuse. It was also supported by the Clinical Core of the Center for AIDS Research at the Albert Einstein College of Medicine and Montefiore Medical Center funded by the National Institutes of Health(NIH AI-51519) Dr. Shuter has received grant support from the American Legacy Foundation and the Abbott Laboratories Investigator Initiated Research Program

Funding Information:
Supported by grants CA87979, CA50385, and K07 CA92696-02 (Cooley) from the National Institutes of Health, and a grant from the Robert Wood Johnson Foundation #55769 (Sarna)

Funding Information:
Study was supported by NIDA R01 DA16708 and NINDS P50 NS19632, and partially by NIDA R01 DA023051, NIDA R01 DA022549, and NCI R01 CA152062

Funding Information:
Prof. Arakawa received lecture fees from Otsuka and Eisai and research grants from Otsuka, Eisai, Astel-las, Abbott Japan,Takeda, Dainippon Sumitomo, and Daiichi Sankyo. The remaining authors have no conflicts to disclose

Funding Information:
GT was funded by a National Coordinating Centre for Research Capacity Development scholarship during the conduct of the study. AG was funded by The National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care for West Midlands(CLAHRC WM) during the conduct of the study. AM receives funding from the UK Centre for Tobacco and Alcohol Studies. GT, AM and PA are part of the UK Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research: Centre of Excellence. Funding from 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

Funding Information:
Outcome measure(s): Patient-Reported Outcomes Measurement Information System (PROMIS); Patient Health Questionnaire 2-item (PHQ-2) Primary funding provided by NCI Grant R01CA141527-01. Additional support provided by NCI Grant 2T32CA163184 and the Center for Chronic Disease Outcomes Research, VA, Minneapolis, MN

Funding Information:
The Japan Environment and Children's Study was funded by the Ministry of the Environment, Japan

Funding Information:
This research project was financed by Fundación Neumosur 7/2008

Funding Information:
Outcome measure(s): Hospital and Depression Anxiety Scale (HADS); HIV/AIDS-Targeted Quality of Life Scale (life-satisfaction subscale) This work was supported by National Institutes of Health [grant number K24 DA045244 and R01 DA033681] and University of Pennsylvania Center for AIDS Research [P30AI045008] and Penn Mental Health AIDS Research Center [P30 MH097488]. Pfizer provided the medication and placebo supply. National Institute of Allergy and Infectious Diseases; National Institute of Mental Health; National Institute on Drug Abuse Dr. Schnoll received medication and placebo free from Pfizer and has provided consultation to Pfizer. Dr. Schnoll has provided consultation to GlaxoSmithKline and CuraLeaf. Dr.Gross serves on a DSMB for a Pfizer medication unrelated to smoking or HIV. No other conflicts are declared

Funding Information:
The SUN Project has received funding from the Spanish Government (current Grants PI10/02658, PI10/02293, PI13/00615, PI14/01798, RD06/0045, G03/140 and 87/2010), the Navarra Regional Government (45/2011, 27/2011) and the University of Navarra

Funding Information:
PA is funded by NIHR Oxford Applied Research Collaboration Cancer Research UK, UK

Publisher Copyright:
Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

ASJC Scopus subject areas

  • Pharmacology (medical)

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