BACKGROUND: Thailand is recognized for its strong tobacco control measures, with Thai nurses playing a key role in tobacco control, particularly in preventing tobacco use and promoting smoking cessation. However, no systematic reviews have synthesized the effects of nurse-led interventions for tobacco control in Thailand. This systematic review and meta-analysis aimed to assess the effectiveness of nurse-led interventions in tobacco control by Thai nurses.
METHODS: Following Cochrane Collaboration guidelines, this review included randomized controlled trials (RCTs) and quasi-experimental studies published between 2005 and 2022. Nurse-led interventions were defined as initiatives where Thai nurses lead health interventions aimed at preventing or reducing smoking behavior. A comprehensive search of five electronic databases and grey literature was conducted. Two independent reviewers screened and extracted data using the Cochrane data extraction form. Meta-analysis was used to synthesize the findings.
RESULTS: Fourteen studies focused on tobacco use prevention, and 44 studies focused on smoking cessation. Nurse-led interventions significantly improved participants' smoking-related knowledge, attitudes, and intentions not to smoke (MD = 4.04, 95% CI: 2.29 to 5.79; MD = 8.54, 95% CI: 2.10 to 14.98; MD = 3.31, 95% CI: 0.81 to 5.82). Compared to control or usual care, nurse-led interventions increased the likelihood of quitting (RR 2.27, 95% CI: 1.72 to 2.98). Most interventions were hospital-based and involved individual cessation counseling. Subgroup analyses showed that nurse-led smoking cessation interventions in the workplace were more effective than those in other settings.
CONCLUSIONS: Nurse-led interventions are effective in improving smoking-related knowledge, changing attitudes, increasing the intention not to smoke, and reducing smoking behavior. However, further methodologically rigorous research is needed in Thailand to strengthen the evidence base.