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Behavioral Therapy and Pharmacotherapy for Relapse Prevention in Abstinent Smokers: Korea Preventive Services Task Force Guidance
J Korean Soc Res Nicotine Tob 2021; 12(1): 8-15
Published online June 15, 2021
© 2021 The Korean Society for Research on Nicotine and Tobacco.

Naae Lee1†, Eon Sook Lee2†, Jae Moon Yun3, Cheol Min Lee4, Seung-Won Oh4, Younglee Choi5, Belong Cho3*, Korea Preventive Services Task Force‡

1Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 2Department of Family Medicine, Ilsan-Paik Hospital, Inje University, Goyang, 3Department of Family Medicine, Seoul National University Hospital, 4Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, 5Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
Correspondence to: 조비룡
서울대학교병원 가정의학과
E-mail: belong@snu.ac.kr
ORCID: https://orcid.org/0000-0001-9558-689X
†공동 제1 저자.
‡질병예방서비스위원회 명단: 이종구(서울대학교 의과대학, 위원장) 김현창(연세대학교 의과대학), 박병주(서울대학교 의과대학), 조종희(서울특별시 북부병원 보건의료복지통합센터), 조정진(한림대학교 의과대학), 조성일(서울대학교 보건대학원), 김수영(한림대학교 의과대학), 이석구(충남대학교 의과대학), 김영재(교보생명부속의원), 임현우(가톨릭대학교 의과대학), 조비룡(서울대학교 의과대학), 신승수(아주대학교 의과대학), 김건엽(경북대학교 의과대학), 이철주(서울대학교 언론정보학과)
Received February 2, 2021; Revised May 20, 2021; Accepted May 22, 2021.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: This paper presents the Korea Preventive Services Task Force (KPSTF) guidance on behavioral and pharmacotherapy for relapse prevention in abstinent smokers.
Methods: Evidence was evaluated at the evidence-based practice center of the KPSTF to develop KPSTF guidance through a rapid systematic review of both behavioral and pharmacologic intervention. Subsequently, evidence level and recommendation grade were examined in accordance with the KPSTF Manual for Public Health Guidance. Consensus on the recommendation grade determined by nine experts was obtained using a modified Delphi method to evaluate the effect size, priority, resources, feasibility, health equity, and reliability of the values and preferences.
Results: This guidance applies to smokers who successfully quit smoking over 24 h on their own (unassisted abstainers), who forcibly quit because of pregnancy or hospitalization, or who quit by participating in a smoking cessation program (assisted abstainers).
Conclusion: The KPSTF does not recommend providing behavioral therapy for abstinent smokers for relapse prevention (Recommendation grade: D, evidence level: high). Instead, it recommends pharmacotherapy, albeit with weak intensity (Recommendation grade: B evidence level: high). A significant effect was confirmed in the relapse prevention intervention in pharmacotherapy, but the effect was not large (RR [95% CI]: 1.15 [1.05, 1.26], I2=40.71%). This recommendation was developed on the basis of diverse drug and foreign data, so evidence should be obtained through randomized clinical trials. However, we cannot conclude if it will have the same effect in Korea. Therefore, a sufficient number of domestic studies and long-term follow-up are required in the future to verify the relapse prevention intervention.
Keywords : Behavioral therapy; Pharmacotherapy; Relapse prevention; Smoking cessation; Guidance
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