The effectiveness of tobacco cessation programs for university students: A systematic review and meta-analysis

INTRODUCTION: This systematic review and meta-analysis aimed to explore the existing tobacco interventions and synthesize whether those interventions affected tobacco use among university students. METHODS: We searched and found 1799 studies in PubMed, ClinicalKey for Nursing, Embase, and SCOPUS between 2009 and 2022. The risk of bias was assessed using similar criteria for RCT and non-randomized studies guided by the Cochrane Handbook for Systematic Reviews. The heterogeneity of studies was evaluated using Cochran’s Q and I(2) index. The GRADE system was used to distinguish the quality of evidence, and Egger’s linear regression test was performed to assess publication bias. RESULTS: Eighteen studies used data extraction and analyses, and only eleven were meta-analyzed, which found that the estimate obtained via the fixed-effects model was statistically significant. Technology-based and motivational interview interventions found pooled ORs of statical significance, while reinforcer interventions showed the smallest effect size. The level of heterogeneity was considered substantial. The assessment for quality of evidence showed low overall certainty of evidence due to imprecision of outcome and suspicion of publication bias. Egger’s test showed no publication bias among included studies (p=0.38). CONCLUSIONS: There were numerous tobacco cessation interventions for university students, but the most effective intervention to change tobacco consumption behavior was still inconclusive and uncertain. TRIAL REGISTRATION: This systematic review was registered with PROSPERO. The registration number is CRD42019142491.