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Journal of Public Health Advance Access originally published online on February 10, 2009
Journal of Public Health 2009 31(2):258-277; doi:10.1093/pubmed/fdp008
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© The Author 2009, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Improving access to smoking cessation services for disadvantaged groups: a systematic review



Rachael L. Murray, Cancer Research UK Graduate Training Fellow1

Linda Bauld, Reader in Social Policy2

Lucy E. Hackshaw, PhD Research Psychologist2

Ann McNeill, Professor of Health Policy and Promotion1
1 Division of Epidemiology and Public Health, UK Centre for Tobacco Control Studies, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK
2 Department of Social and Policy Sciences, UK Centre for Tobacco Control Studies, University of Bath, Bath, UK

Address correspondence to Rachael Murray, E-mail: rachael.murray{at}nottingham.ac.uk


  Abstract

Background Smoking is a main contributor to health inequalities. Identifying strategies to find and support smokers from disadvantaged groups is, therefore, of key importance.

Methods A systematic review was carried out of studies identifying and supporting smokers from disadvantaged groups for smoking cessation, and providing and improving their access to smoking-cessation services. A wide range of electronic databases were searched and unpublished reports were identified from the national research register and key experts.

Results Over 7500 studies were screened and 48 were included. Some papers were of poor quality, most were observational studies and many did not report findings for disadvantaged smokers. Nevertheless, several methods of recruiting smokers, including proactively targeting patients on General Physician's registers, routine screening or other hospital appointments, were identified. Barriers to service use for disadvantaged groups were identified and providing cessation services in different settings appeared to improve access. We found preliminary evidence of the effectiveness of some interventions in increasing quitting behaviour in disadvantaged groups.

Conclusions There is limited evidence on effective strategies to increase access to cessation services for disadvantaged smokers. While many studies collected socioeconomic data, very few analysed its contribution to the results. However, some potentially promising interventions were identified which merit further research.

Keywords: access, disadvantage, inequalities, smoking cessation services


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