Effectiveness of Cognitive Behavioral Therapy Compared with Basic Health Education for Tobacco Cessation: A Systematic Review
Gagan Raj, Ankita JainAbstract
Background:
Tobacco use remains one of the leading preventable causes of morbidity and mortality worldwide. Cognitive behavioural therapy (CBT) and basic health education (BHE) are widely used behavioural interventions for smoking cessation, but their comparative effectiveness has not been comprehensively synthesized. This systematic review evaluated whether CBT is more effective than BHE in improving smoking cessation outcomes among adult smokers.
Methods:
Following a registered PROSPERO protocol (CRD420251131784) and PRISMA 2020 guidelines, randomized and controlled trials comparing CBT with BHE or usual care were included. Smoking abstinence was the primary outcome, while reduction in cigarette consumption, nicotine dependence, cognition, and self-efficacy were secondary outcomes.
Results:
Twenty-two studies met the eligibility criteria. Most studies reported higher smoking abstinence rates, greater reductions in nicotine dependence, and improved self-efficacy with CBT compared with BHE, particularly when CBT was intensive or combined with pharmacotherapy. However, heterogeneity in intervention intensity, participant characteristics, and outcome measures limited direct comparison across studies. Some studies found no significant differences between interventions, especially where nicotine replacement therapy was provided to all participants.
Conclusions:
Overall, the available evidence suggests that CBT is generally more effective than BHE in promoting tobacco cessation, although further high-quality studies using standardized intervention protocols and outcome measures are needed.