The effects of a smoking cessation intervention on 14.5-year mortality - A randomized clinical trial
The effects of a smoking cessation intervention on 14.5-year mortality - A randomized clinical trial
复制标题
DOI：
10.7326/0003-4819-142-4-200502150-00005
复制
发表时间：
2005-02-15
影响因子：
39.2
通讯作者：
Connett, JE
中科院分区：
文献类型：
--
作者：
Anthonisen, NR;Skeans, MA;Connett, JE
背景资料：随机临床试验尚未证明的死亡率效益的戒烟。目的：要评估的长期影响对死亡率的随机应用的戒烟program.Design：肺健康研究是一项随机临床试验的戒烟。特殊干预参与者接受吸烟干预计划，并与常规护理参与者进行比较。生命状态随访长达14.5年。设置：美国和加拿大的10个临床中心。患者：5887例无症状气道阻塞的中年志愿者。测量：全因死亡率和心血管疾病、肺癌和其他呼吸系统疾病导致的死亡率。干预：干预是一个为期10周的戒烟计划，其中包括一个强有力的医生信息和12个小组会议使用行为矫正和尼古丁口香糖，加上异丙托溴铵或安慰剂吸入器。在5年时，21.7%的特殊干预参与者自研究开始以来已经戒烟，而常规护理参与者为5.4%。经过长达14.5年的随访，731名患者死亡：33%的肺癌，22%的心血管疾病，7.8%的癌症以外的呼吸系统疾病，2.3%的原因不明。特殊干预组的全因死亡率显著低于常规护理组（8.83/1000人-年vs. 10.38/1000人-年; P = 0.03）。常规护理组与特殊干预组相比的死亡风险比为1.18（95%CI，1.02 - 1.37）。肺癌和心血管疾病的死亡率差异较大时，死亡率进行了分析吸烟habitation.Limitations：结果仅适用于个人与airway obstruction. Conclusion：戒烟干预计划可以有一个实质性的影响，随后的死亡率，即使在少数成功的参与者。
Background: Randomized clinical trials have not yet demonstrated the mortality benefit of smoking cessation.Objective: To assess the long-term effect on mortality of a randomly applied smoking cessation program.Design: The Lung Health Study was a randomized clinical trial of smoking cessation. Special intervention participants received the smoking intervention program and were compared with usual care participants. Vital status was followed up to 14.5 years.Setting: 10 clinical centers in the United States and Canada.Patients: 5887 middle-aged volunteers with asymptomatic airway obstruction.Measurements: All-cause mortality and mortality due to cardiovascular disease, lung cancer, and other respiratory disease.Intervention: The intervention was a 10-week smoking cessation program that included a strong physician message and 12 group sessions using behavior modification and nicotine gum, plus either ipratropium or a placebo inhaler.Results: At 5 years, 21.7% of special intervention participants had stopped smoking since study entry compared with 5.4% of usual care participants. After up to 14.5 years of follow-up, 731 patients died: 33% of lung cancer, 22% of cardiovascular disease, 7.8% of respiratory disease other than cancer, and 2.3% of unknown causes. All-cause mortality was significantly lower in the special intervention group than in the usual care group (8.83 per 1000 person-years vs. 10.38 per 1000 person-years; P = 0.03). The hazard ratio for mortality in the usual care group compared with the special intervention group was 1.18 (95% CI, 1.02 to 1.37). Differences in death rates for both lung cancer and cardiovascular disease were greater when death rates were analyzed by smoking habit.Limitations: Results apply only to individuals with airway obstruction.Conclusion: Smoking cessation intervention programs can have a substantial effect on subsequent mortality, even when successful in a minority of participants.