Supporting smoking cessation and preventing relapse following a stay in a smokefree setting: A meta-analysis and investigation of effective behaviour change techniques.
Supporting smoking cessation and preventing relapse following a stay in a smokefree setting: A meta-analysis and investigation of effective behaviour change techniques.
复制标题
支持戒烟并防止在无烟环境中复吸：对有效行为改变技术的荟萃分析和调查。
作者：
Emily Shoesmith;L. Huddlestone;F. Lorencatto;L. Shahab;S. Gilbody;E. Ratschen
背景与目的
进入无烟环境提供了一个独特的机会，鼓励吸烟者戒烟。然而，出院后复发的风险很高，并且对出院后支持戒烟的有效策略知之甚少。我们的目的是确定在无烟期后保持戒烟的干预措施，并确定其有效性，以及在这些干预措施中使用的行为改变技术（BCT）的可能有效性。
方法
为遵守机构无烟政策而暂时或完全戒烟的≥ 18岁成年吸烟者研究的系统性综述和荟萃分析。机构包括监狱、住院精神卫生、药物滥用或急性医院环境。使用经生化验证的禁欲（7天时点患病率或持续禁欲）对随机对照试验（RCT）进行Mantel-Haenszel随机效应荟萃分析。BCT在可能的有效性（如果BCT存在于≥2种长期有效的干预措施中）和可行性（如果BCT也在≥25%的所有干预措施中提供）方面被定义为“有希望”。
结果
纳入了37项研究（干预n= 9，041，对照n= 6，195）：23项RCT（干预n= 6，593，对照n= 5，801）; 3项非随机试验（干预n=845，对照n=394）和11项队列研究（n= 1，603）。在最长随访期（4周至18个月），对经生化验证的禁欲（n= 8，544）进行荟萃分析，发现总体效果有利于干预[风险比（RR）=1.27，95%置信区间（CI）1.08 - 1.49，I2 =42%]。9项BCT（包括“药物支持”、“目标设定（行为）”和“社会支持”）在可能的有效性和可行性方面被定性为“有希望”。
结论
一项系统性综述和荟萃分析表明，行为和药理学支持在无烟机构停留后可有效维持戒烟。几种行为改变技术可能有助于维持戒烟至出院后18个月。
BACKGROUND AND AIMS
Admission to a smokefree setting presents a unique opportunity to encourage smokers to quit. However, risk of relapse post-discharge is high, and little is known about effective strategies to support smoking cessation following discharge. We aimed to identify interventions that maintain abstinence following a smokefree stay and determine their effectiveness, as well as the likely effectiveness of Behaviour Change Techniques (BCTs) used in these interventions.
METHOD
Systematic review and meta-analyses of studies of adult smokers ≥ 18 years of age who were temporarily or fully abstinent from smoking to comply with institutional smokefree policies. Institutions included prison, inpatient mental health, substance misuse or acute hospital settings. A Mantel-Haenszel random effects meta-analysis of randomised controlled trials (RCTs) was conducted using biochemically verified abstinence (7-day point prevalence or continuous abstinence). BCTs were defined as 'promising' in terms of likely effectiveness (if BCT was present in ≥2 long-term effective interventions) and feasibility (if BCT was also delivered in ≥25% of all interventions).
RESULTS
Thirty-seven studies (intervention n=9,041, control n=6,195) were included: 23 RCTs (intervention n=6,593, control n=5,801); three non-randomised trials (intervention n=845, control n=394), and 11 cohort studies (n=1,603). Meta-analysis of biochemically-verified abstinence (n=8,544) at longest follow-up (4 weeks to 18 months) found an overall effect in favour of intervention [risk ratio (RR)=1.27, 95% confidence interval (CI) 1.08 - 1.49, I2 =42%]. Nine BCTs (including 'pharmacological support', 'goal setting (behaviour)' and 'social support') were characterised as 'promising' in terms of likely effectiveness and feasibility.
CONCLUSION
A systematic review and meta-analyses indicate that behavioural and pharmacological support is effective in maintaining smoking abstinence following a stay in a smokefree institution. Several behaviour change techniques may help to maintain smoking abstinence up to 18 months post-discharge.
影响因子：
8.4
作者：
Rigotti, Nancy A;Clair, Carole;Munafo, Marcus R;Stead, Lindsay F
通讯作者：
Stead, Lindsay F
在 Helping HAND 2 随机对照试验中检查非法药物使用对戒烟结果的影响。
影响因子：
4.2
作者：
Streck,JoannaM;Regan,Susan;Chang,Yuchiao;Kelley,JenniferHK;Singer,DanielE;Rigotti,NancyA
通讯作者：
Rigotti,NancyA
DOI：
10.1080/00952990.2018.1467431
发表时间：
2018
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
McClure EA;Tomko RL;Carpenter MJ;Treiber FA;Gray KM
通讯作者：
Gray KM