Effectiveness of Smoking Cessation Interventions among Indigenous Populations: A Systematic Review
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Abstract
Background: Indigenous populations globally experience disproportionately high smoking rates compared to non-indigenous groups, underscoring the need for tailored cessation interventions. This systematic review evaluates the effectiveness of smoking cessation strategies specifically designed for Indigenous populations. Methods: A systematic review was conducted following PRISMA guidelines, assessing trials published from 2014 to 2024. Databases searched included the Web of Science, Cochrane Library, SCOPUS, PUBMED, and Google Scholar with a predetermined filter, yielding 2,733 titles and abstracts. Eligible studies included: i) randomised controlled trials (RCTs) and quasi-randomised controlled trials published from 2014 to 2024, ii) involved Indigenous active smokers, and iii) focused on specific smoking cessation interventions. The risk of bias was evaluated via the Cochrane Risk of Bias Tool for RCTs (RoB 2.0), and the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I). Results: 14 studies met the inclusion criteria, encompassing pharmacological, behavioural, cultural, and combined interventions. Interventions incorporating cultural adaptation, community engagement, and early involvement with Indigenous populations demonstrated greater effectiveness. Discussion: Findings suggest that successful cessation strategies for Indigenous populations are those that integrate holistic, culturally safe, and community-driven approaches. However, this study is limited by the lack of longitudinal studies assessing long-term cessation maintenance and tobacco use outcomes. Impact: This review highlights the importance of culturally relevant smoking cessation strategies, providing a framework for future interventions and research aimed at Indigenous groups, thereby addressing health disparities in smoking-related outcomes.
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