Scoping review finds support for combined smoking-cessation care in primary care

A systematic scoping review included 30 studies published from 2020 to 2024 on cessation interventions and implementation strategies in primary care in high-income countries. Evidence most strongly supported combining behavioural counselling with pharmacotherapy; only two studies included e-cigarette users, limiting conclusions about vaping cessation.

Review included 30 studies from high-income countries.
Combined counselling and pharmacotherapy had the strongest support.
Only two studies included e-cigarette users.
Provider-education evidence was inconclusive.

Researchers searched PubMed and EMBASE for empirical studies of smoking or vaping cessation interventions in primary care settings in Australia, Canada, the EU, the UK and the US. Two reviewers screened 2,166 records and included 30 peer-reviewed studies. The review examined abstinence and other outcomes, alongside intervention and implementation approaches; it used a narrative synthesis rather than a pooled estimate of effect.

Most studies focused on smoking cessation. The strongest evidence described multi-component interventions combining behavioural counselling and pharmacological treatment. Reported implementation strategies included electronic health record prompts, cost-free pharmacotherapy, financial incentives, and linking cessation support with low-dose CT screening or post-spirometry feedback. Evidence on provider education was inconclusive.

The findings support integrating combined smoking-cessation support into primary care, but the review does not establish a single best implementation approach or quantify comparative effects. Evidence from vaping-specific cessation studies was particularly limited: only two included e-cigarette users, and reporting did not allow firm conclusions about vaping abstinence. The review covered studies from selected high-income settings, so findings may not apply to other health systems.

In practice

For people who smoke and receive primary care, the review finds the strongest evidence for cessation interventions that combine behavioural counselling with pharmacological treatment. It also identifies system approaches—including electronic health record prompts and cost-free pharmacotherapy—that have been evaluated to support delivery. This is a scoping review with narrative synthesis, not a pooled estimate or comparison establishing one optimal model. Evidence for vaping cessation is insufficient to draw firm conclusions, so the findings do not establish an effective vaping-specific approach.

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Source

Journal of General Internal Medicine: Evidence for Embedding Smoking and Vaping Cessation Support in Primary Care: A Scoping Review ↗

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