In several high-income countries, there has been an increase in public awareness of the harm caused by smoking tobacco, and a general decrease in smoking rates. Low- and middle-income countries (LMIC) on the other hand, remain a large and vulnerable market for tobacco products. The growth in smoking rates is followed ten to twenty years later by an increase in the incidence of noncommunicable diseases. It is therefore important that efforts to control the consumption of tobacco in LMIC are strengthened. We systematically reviewed the literature to identify randomized and quasi-randomised studies of interventions for tobacco control implemented in LMIC.

We included 45 studies conducted in various low- and middle-income countries. The interventions were broadly on offering help to quit smoking and included pharmacotherapy, health education targeting smoking pregnant women or their husbands, or at the community or primary health care. Studies on school-based interventions and one study on warnings on the dangers of smoking tobacco were also included.

In low- and middle-income countries:

• Nicotine replacement therapy and buproprion may help smokers to stop smoking and probably reduces smoking rates.
• Health education that targets smoking pregnant women probably helps them to stop smoking, and may result in one or more quit attempts or a reduction in the amount of smoking.
• We are uncertain of the effect of health education at the primary care or community level on smoking cessation; however health education may decrease overall smoking rates.
• School-based interventions probably prevent progression to regular smoking among experimenters or non smokers. These interventions may reduce overall smoking rates and improve life skills and probably improve knowledge, attitudes and beliefs about the effects of tobacco smoking. We are uncertain if school-based interventions prevent experimentation with cigarettes.