Effectiveness of community-based tobacco cessation programs in promoting tobacco abstinence: a systematic review and meta-analysis

Background Community-based tobacco cessation programs may improve access to cessation support, particularly among populations facing barriers to conventional healthcare services. This systematic review evaluated the effectiveness of community-based tobacco cessation programs in promoting tobacco abstinence and improving cessation-related outcomes.Methods A systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420261438491). PubMed, Scopus, Google Scholar, Cochrane Library, and the Virtual Health Library Regional Portal were searched for studies published from January 2016 to January 2026. Randomized and non-randomized interventional studies evaluating community-based tobacco cessation programs were eligible. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence was assessed using GRADE. The primary meta-analysis included randomized trials reporting biochemically validated tobacco abstinence at six months with sufficiently comparable intervention–comparator contrasts.Results Of 20,546 records identified, 11 studies were included, comprising six randomized and five non-randomized studies. Two randomized trials were included in the primary meta-analysis. The pooled estimate suggested a higher relative risk of biochemically validated tobacco abstinence at six months, although the effect was not statistically significant (RR = 1.34, 95% CI: 0.90–1.98; p = 0.147; I2 = 35.2%). Other studies reported variable effects on abstinence and cessation-related outcomes. The certainty of evidence was low.Conclusion Evidence for the effectiveness of community-based tobacco cessation programs remains uncertain. Larger randomized trials using standardized, biochemically validated outcomes and longer follow-up are needed.