Population effectiveness of pharmaceutical aids for smoking cessation: What is associated with increased success?
Population effectiveness of pharmaceutical aids for smoking cessation: What is associated with increased success?
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DOI：
10.1080/14622200600910801
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发表时间：
2006-10-01
影响因子：
4.7
通讯作者：
Pierce, John P.
中科院分区：
文献类型：
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作者：
Gilpin, Elizabeth A.;Messer, Karen;Pierce, John P.
尽管尼古丁替代疗法 (NRT) 在随机对照试验中显示出疗效，但在非处方药上市后，人群有效性似乎有所下降。本研究检验了安非他酮的人群有效性。它还研究了一般药物辅助使用（NRT、安非他酮或两者）的人群有效性是否可能受到环境因素的影响：拥有无烟家庭（可能表明戒烟动机）或家庭中没有其他吸烟者。将 1999 年和 2002 年加州烟草调查的大规模人口横断面数据合并起来，以提高对去年最近一次戒烟尝试后的戒烟持续时间进行亚组分析的统计能力。调查前一年每天中度至重度吸烟者（至少 15 支/天）（N=2,640）是主要关注点。考克斯比例风险分析表明，安非他酮是有效的，甚至从长远来看也是如此。进一步的分析发现，拥有无烟家庭和使用任何药物辅助（NRT、安非他酮或两者）之间，以及拥有无烟家庭和家中没有其他吸烟者之间的戒烟持续时间存在显着的相互作用。尽管如果家庭没有无烟，药物辅助可能会产生轻微的短期益处，但如果家庭无烟，无论从短期还是长期来看，它们似乎都特别有效。加利福尼亚州的人口经验支持这样一项政策，即补贴药物援助以帮助吸烟者戒烟（特别是安非他酮，如果合适的话）应该针对那些已经采取行为行动（例如建立无烟家庭）的高度积极的吸烟者。
Although nicotine replacement therapy (NRT) has shown efficacy in randomized controlled trials, population effectiveness has appeared to diminish after it became available over the counter. The present study examined the population effectiveness of bupropion. It also examined whether population effectiveness of pharmaceutical-aid use in general (NRT, bupropion, or both) might be influenced by environmental factors: Having a smoke-free home (possible indication of motivation to quit) or no other smoker in the household. Data from the large population-based cross-sectional 1999 and 2002 California Tobacco Surveys were combined to improve statistical power for subgroup analyses of duration of abstinence following the most recent quit attempt in the past year. Moderate-to-heavy daily smokers (at least 15 cigarettes/day) a year prior to the survey (N=2,640) were the main focus. A Cox proportional-hazards analysis suggested that bupropion was effective, perhaps even in the longer term. Further analyses identified significant interactions on abstinence duration between having a smoke-free home and any pharmaceutical-aid use (NRT, bupropion, or both), and between having a smoke-free home and no other smoker in the household. Although pharmaceutical aids may have had a slight short-term benefit if the home was not smoke free, they appeared particularly effective if the home was smoke free, both in the short and longer term. The California population experience supports the policy that programs subsidizing pharmaceutical aids to help smokers quit ( particularly bupropion, if appropriate) should target highly motivated smokers who have already taken a behavioral action, such as implementing a smoke-free home.