Do smoking reduction interventions promote cessation in smokers not ready to quit?
Do smoking reduction interventions promote cessation in smokers not ready to quit?
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DOI：
10.1016/j.addbeh.2011.02.003
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发表时间：
2011-07
影响因子：
4.4
通讯作者：
Relyea, George E.
中科院分区：
文献类型：
--
作者：
Asfar, Taghrid;Ebbert, Jon O.;Klesges, Robert C.;Relyea, George E.
关键词：
对于没有准备好戒烟的吸烟者来说，治疗选择有限。减少吸烟可能是一种可行的治疗方法，如果证明可以增加长期戒烟的比例。对随机对照试验进行了系统回顾，这些试验在未准备好戒烟尝试（立即或下个月）的吸烟者中测试了减少吸烟干预措施（药理学，行为或两者结合），以评估这些策略在促进未来戒烟方面的有效性。主要结局是最长随访（≥ 6个月）时的7天时点戒烟率。纳入了10项试验; 6项测试了药理干预措施，1项评估了行为干预措施，3项评估了联合干预措施。药物干预（2732例受试者; OR 2.33，95% CI 1.43 - 3.79）和联合干预（638例受试者; OR 2.14，95% CI：1.28 - 3.60）减少吸烟显著增加了长期戒烟率。关于行为戒烟干预的有效性证据不足（320名参与者; OR 1.49，95%CI 0.56至3.93）。进一步的研究，以评估减少吸烟的疗效应停止作为一个终点，重点是明确和一致性的患者选择，并确定尼古丁替代疗法通过协助减少吸烟增加戒烟率的机制。
Limited treatment options exist for smokers who are not ready to make a quit attempt. Smoking reduction may be a viable treatment approach if proven to increase the rates of long-term abstinence from smoking. A systematic review of randomized, controlled trials that tested smoking-reduction interventions (pharmacological, behavioral, or both combined) among smokers who were not ready to make a quit attempt (immediately or in the next month) was conducted to assess the efficacy of these strategies in promoting future smoking abstinence. The primary outcome was the 7-day point-prevalence smoking abstinence at longest follow-up (≥ 6 months). Ten trials were included; six tested pharmacologic interventions, one evaluated a behavioral intervention, and three evaluated combined interventions. Pharmacologic (2732 participants; OR 2.33, 95% CI 1.43 to 3.79) and combined (638 participants; OR 2.14, 95% CI: 1.28 to 3.60) smoking-reduction interventions significantly increased long-term abstinence from smoking. Insufficient evidence was available on the efficacy of behavioral smoking-reduction interventions (320 participants; OR 1.49, 95% CI 0.56 to 3.93). Further research to evaluate the efficacy of smoking reduction should have cessation as an endpoint, focus on clarity and consistency in patient selection, and identify the mechanism through which nicotine replacement therapy assisted smoking reduction in increasing abstinence rates.
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