Can system change interventions help to stop smoking?

System change interventions, including staff training and policies for identification of smokers and provision of smoking cessation treatment and advice by clinicians or by specialists, had uncertain effects on abstinence from smoking at 6 to 24 months, as well as on quitline referral and quitline enrollment, but may have led to better counseling rates, improvements in asking about tobacco use or providing cessation advice, and a greater proportion of people initiating nicotine replacement therapy or other pharmacotherapy. Given that all available evidence was of very low to low certainty, no firm conclusions can be drawn. Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina