Quality of smoking cessation advice in guidelines of tobacco-related diseases: An updated systematic review

Winifred Ekezie*, Rachael L. Murray, Sanjay Agrawal, Ilze Bogdanovica, John Britton, Jo Leonardi-Bee

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Tobacco smoking is a major risk factor for a wide range of diseases, and smoking cessation significantly reduces these risks. Clinical guidelines for diseases associated with smoking should therefore include guidance on smoking cessation. This review updated evidence on the proportion of clinical guidelines that do so. We conducted a systematic review investigating clinical guidelines and recommendations developed by UK national or European transnational medical specialty associations and societies between January 2014 and October 2019 on 16 diseases to be at least twice as common among smokers than non-smokers. Outcomes of interest were the reporting of smoking as a risk factor, and the inclusion either of smoking cessation advice or referral to other cessation guidance. We compared our findings with an earlier review of guidelines published between 2000 and 2013. We identified 159 clinical guidelines/recommendations. Over half (51%) made no mention of smoking, while 43% reported smoking as a risk factor for the development of the disease, 31% recommended smoking cessation and 19% provided detailed information on how to deliver smoking cessation support. These proportions were similar to those in our earlier review. Smoking cessation continues to be neglected in clinical management guidance for diseases caused by smoking.

Original languageEnglish
Pages (from-to)551-559
Number of pages9
JournalClinical Medicine, Journal of the Royal College of Physicians of London
Issue number6
Publication statusPublished - 16 Nov 2020

Bibliographical note

Funding Information:
The work was funded by Cancer Research UK.


  • Guidelines
  • Smoking
  • Smoking cessation
  • Systematic review


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