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Introduction
Tobacco smoking is the most prevalent health risk behaviour globally. Recently the trend of smoking and tobacco use has been increasing in developing countries. The World Health Organization (WHO) has emphasized the priority need for tobacco control ('WHO: Report on the global tobacco epidemic, 2013,' 2014). Currently, tobacco-related health problems kill 5.4 million people per year- one person every six seconds- with 70-80% of those deaths confined to developing countries ('WHO: Tobacco Free Initiative (TFI): Tobacco Fact,' 2014). While those developing countries are witnessing a smoking epidemic and with it rising death tolls, smoking-cessation services are not available in primary care settings (Piné-Abata et al., 2013).
Evidence has shown that the mere existence of a smoking-cessation programme can improve long term survival, even if it leads to just a minority of the smokers to successfully stop smoking. (Anthonisen et al., 2005). However, a recent global survey reported that more than half of the countries surveyed lacked an official national treatment strategy, as well as national treatment guidelines and clearly assigned government officials for smoking-cessation therapy (Piné-Abata et al., 2013). Therefore, smoking cessation intervention is an urgent but largely inaccessible health service.
Treatment of tobacco dependence in routine primary care requires properly strengthening of health system ('WHO: TFI: Strengthening health systems for treating tobacco dependence in primary care,' 2013). The challenges to successful implementation of smoking cessation interventions differ markedly between countries. Reviewing the pros and cons of smoking cessation intervention in the global literature may help to indicate the most effective way to integrate tobacco addiction treatment into routine primary care. Ultimately, this review aims to provide advice on the best strategies for launching smoking cessation services within the primary care settings of developing countries.
The literature review is based on PubMed citations and Cochrane reviews on smoking cessation intervention, as well as strategic searches using the keywords: 'smoking cessation'. The literature search was filtered as (1) research with an outcome of smoking cessation for six months (2) articles published after 2000 indexed in the PubMed database. Risk ratios in the Cochrane review pooled analyses were appraised in terms of the efficacy of each smoking cessation methods; otherwise randomized controlled clinical trials with an outcome of smoking cessation of more than six months...