加强戒烟热线的有效性：寻找更好的辅助药物治
2012/12/13
摘要
简介：电话戒烟热线有助于戒烟，而且应用广泛。2010年，在美国就有超过500000名呼叫者进行戒烟热线咨询。本试验研究3个不同的增强戒烟热线效果的措施的有效性和成本-效益：联合尼古丁替代治疗（NRT）、长时间NRT和增加NRT依从性的咨询。
方法：本研究中，987名戒烟热线呼叫者随机分为联合戒烟热线治疗，采用2×2 × 2因素设计：NRT持续时间（2周 vs 6周）、NRT类型（仅尼古丁贴剂 vs贴剂联合尼古丁口香糖）和标准4次咨询（SC）vs SC联合药物依从性咨询（MAC）。主要转归为6个月时意向治疗（ITT）分析的7天点戒断率（PPA）。
结果：与2周尼古丁贴剂治疗相比，联合NRT治疗6周，6个月时具有最高的PPA（51.6%；OR= 1.71，95% CI：1.20-2.45）。2周联合NRT治疗也观察类似结果（48.2%；OR = 1.49，95% CI: 1.04-2.14），但6周单独尼古丁贴剂治疗未观察到上述结果（46.2%，OR = 1.38，95% CI: 0.96-1.97）。MAC干预的效果不显著。费用分析显示，2周联合NRT戒断治疗的费用最低（2周单独贴剂戒烟：$442 vs. $464；6周单独贴剂戒烟：$505；6周联合NRT：$675）。
结论：通过戒烟热线咨询时，与2周尼古丁贴剂相比，2周或6周联合NRT可在6个月时分别增加10%和13%的戒断率。如果每年有500000名戒烟热线呼叫者，10%的改善每年可潜在增加50000名戒烟者。
（林江涛 审校）
Nicotine Tob Res. 2012 Sep 19. [Epub ahead of print]
Enhancing Tobacco Quitline Effectiveness: Identifying a Superior Pharmacotherapy Adjuvant.
Smith SS, Keller PA, Kobinsky KH, Baker TB, Fraser DL, Bush T, Magnusson B, Zbikowski SM, McAfee TA, Fiore MC.
Source
Corresponding Author: Stevens S. Smith, Ph.D., UW Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711, USA. Telephone: 608-262-7563; Fax: 608-265-3102; E-mail: sss@ctri.medicine.wisc.edu.
Abstract
INTRODUCTION: Telephone tobacco quitlines are effective and are widely used, with more than 500,000 U.S. callers in 2010. This study investigated the clinical effectiveness and cost-effectiveness of 3 different quitline enhancements: combination nicotine replacement therapy (NRT), longer duration of NRT, and counseling to increase NRT adherence.
METHODS: In this study, 987 quitline callers were randomized to a combination of quitline treatments in a 2×2 × 2 factorial design: NRT duration (2 vs. 6 weeks), NRT type (nicotine patch only vs. patch plus nicotine gum), and standard 4-call counseling (SC) versus SC plus medication adherence counseling (MAC). The primary outcome was 7-day point-prevalence abstinence (PPA) at 6 months postquit in intention-to-treat (ITT) analyses.
RESULTS: Combination NRT for 6 weeks yielded the highest 6-month PPA rate (51.6%) compared with 2 weeks of nicotine patch (38.4%), odds ratios [OR] = 1.71 (95% confidence interval [CI]:1.20-2.45). A similar result was found for 2 weeks of combination NRT (48.2%), OR = 1.49 (95% CI: 1.04-2.14) but not for 6 weeks of nicotine patch alone (46.2%), OR = 1.38 (95% CI: 0.96-1.97). The MAC intervention effect was nonsignificant. Cost analyses showed that the 2-week combination NRT group had the lowest cost per quit ($442 vs. $464 for 2-week patch only, $505 for 6-week patch only, and $675 for 6-week combination NRT).
CONCLUSIONS: Combination NRT for 2 or 6 weeks increased 6-month abstinence rates by 10% and 13%, respectively, over rates produced by 2 weeks of nicotine patch when offered with quitline counseling. A 10% improvement would potentially yield an additional 50,000 quitters annually, assuming 500,000 callers to U.S. quitlines per year.
Nicotine Tob Res. 2012 Sep 19. [Epub ahead of print]
简介：电话戒烟热线有助于戒烟，而且应用广泛。2010年，在美国就有超过500000名呼叫者进行戒烟热线咨询。本试验研究3个不同的增强戒烟热线效果的措施的有效性和成本-效益：联合尼古丁替代治疗（NRT）、长时间NRT和增加NRT依从性的咨询。
方法：本研究中，987名戒烟热线呼叫者随机分为联合戒烟热线治疗，采用2×2 × 2因素设计：NRT持续时间（2周 vs 6周）、NRT类型（仅尼古丁贴剂 vs贴剂联合尼古丁口香糖）和标准4次咨询（SC）vs SC联合药物依从性咨询（MAC）。主要转归为6个月时意向治疗（ITT）分析的7天点戒断率（PPA）。
结果：与2周尼古丁贴剂治疗相比，联合NRT治疗6周，6个月时具有最高的PPA（51.6%；OR= 1.71，95% CI：1.20-2.45）。2周联合NRT治疗也观察类似结果（48.2%；OR = 1.49，95% CI: 1.04-2.14），但6周单独尼古丁贴剂治疗未观察到上述结果（46.2%，OR = 1.38，95% CI: 0.96-1.97）。MAC干预的效果不显著。费用分析显示，2周联合NRT戒断治疗的费用最低（2周单独贴剂戒烟：$442 vs. $464；6周单独贴剂戒烟：$505；6周联合NRT：$675）。
结论：通过戒烟热线咨询时，与2周尼古丁贴剂相比，2周或6周联合NRT可在6个月时分别增加10%和13%的戒断率。如果每年有500000名戒烟热线呼叫者，10%的改善每年可潜在增加50000名戒烟者。
（林江涛 审校）
Nicotine Tob Res. 2012 Sep 19. [Epub ahead of print]
Enhancing Tobacco Quitline Effectiveness: Identifying a Superior Pharmacotherapy Adjuvant.
Smith SS, Keller PA, Kobinsky KH, Baker TB, Fraser DL, Bush T, Magnusson B, Zbikowski SM, McAfee TA, Fiore MC.
Source
Corresponding Author: Stevens S. Smith, Ph.D., UW Center for Tobacco Research and Intervention, 1930 Monroe St., Suite 200, Madison, WI 53711, USA. Telephone: 608-262-7563; Fax: 608-265-3102; E-mail: sss@ctri.medicine.wisc.edu.
Abstract
INTRODUCTION: Telephone tobacco quitlines are effective and are widely used, with more than 500,000 U.S. callers in 2010. This study investigated the clinical effectiveness and cost-effectiveness of 3 different quitline enhancements: combination nicotine replacement therapy (NRT), longer duration of NRT, and counseling to increase NRT adherence.
METHODS: In this study, 987 quitline callers were randomized to a combination of quitline treatments in a 2×2 × 2 factorial design: NRT duration (2 vs. 6 weeks), NRT type (nicotine patch only vs. patch plus nicotine gum), and standard 4-call counseling (SC) versus SC plus medication adherence counseling (MAC). The primary outcome was 7-day point-prevalence abstinence (PPA) at 6 months postquit in intention-to-treat (ITT) analyses.
RESULTS: Combination NRT for 6 weeks yielded the highest 6-month PPA rate (51.6%) compared with 2 weeks of nicotine patch (38.4%), odds ratios [OR] = 1.71 (95% confidence interval [CI]:1.20-2.45). A similar result was found for 2 weeks of combination NRT (48.2%), OR = 1.49 (95% CI: 1.04-2.14) but not for 6 weeks of nicotine patch alone (46.2%), OR = 1.38 (95% CI: 0.96-1.97). The MAC intervention effect was nonsignificant. Cost analyses showed that the 2-week combination NRT group had the lowest cost per quit ($442 vs. $464 for 2-week patch only, $505 for 6-week patch only, and $675 for 6-week combination NRT).
CONCLUSIONS: Combination NRT for 2 or 6 weeks increased 6-month abstinence rates by 10% and 13%, respectively, over rates produced by 2 weeks of nicotine patch when offered with quitline counseling. A 10% improvement would potentially yield an additional 50,000 quitters annually, assuming 500,000 callers to U.S. quitlines per year.
Nicotine Tob Res. 2012 Sep 19. [Epub ahead of print]
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烟草警示图标对吸烟行为的影响：来自加拿大经
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怀孕的吸烟者使用药物戒烟的疗效和安全性：荟
