Impact of over-the-counter sales on effectiveness of pharmaceutical aids for smoking cessation
Impact of over-the-counter sales on effectiveness of pharmaceutical aids for smoking cessation
复制标题
DOI：
10.1001/jama.288.10.1260
复制
发表时间：
2002-09-11
影响因子：
120.7
通讯作者：
Gilpin, EA
中科院分区：
文献类型：
--
作者：
Pierce, JP;Gilpin, EA
背景成功戒烟是一个主要的公共健康目标。在对照临床试验中，尼古丁替代疗法(NRT)和抗抑郁剂安非他酮被证明只对中到重度吸烟者(大于或等于15支/天)显著提高戒烟率。尼古丁替代疗法被制药业和控烟倡导者大力推广到普通人群中。目的检查加州普通人群中戒烟的趋势、药物戒烟辅助剂的使用和戒烟成功。设计、设置和参与1992、1996和1999年基于大规模人群的加州烟草调查，分别包括5247(应答率71.3%)、9725(应答率72.9%)和6412(应答率68.4%)受访者。主要结果衡量去年吸烟者尝试戒烟(大于或等于1天)的比率，结果1992-1999年间，加州吸烟者戒烟尝试增加了61.4%(从38.1%增加到61.5%)，NRT使用率增加了50.5%(从9.3%增加到14.0%)。1999年，总共有17.2%的戒烟者使用NRT，一种抗抑郁药，或两者兼而有之，作为戒烟的辅助手段。在1996年和1999年，援助使用的中位数持续时间(14天)远远低于推荐值，只有大约20%的使用者接受过辅助性一对一或团体行为咨询。在每个调查年度，在中度到重度吸烟者中，使用NRT可以增加短期戒烟成功率。然而，只有在NRT成为广泛的非处方药(1996年8月)之前，才能观察到长期的戒断优势。1999年，近60%的加州吸烟者被归类为轻度吸烟者，无论从短期还是长期来看，药物援助使用者都没有看到任何好处(
Context Successful smoking cessation is a major public health goal. In controlled clinical trials, nicotine replacement therapy (NRT) and the antidepressant bupropion have been shown to significantly increase cessation rates only for moderate to heavy smokers ( greater than or equal to15 cigarettes/d). Nicotine replacement therapy is heavily promoted to the general population by both the pharmaceutical industry and tobacco control advocates.Objective To examine trends in smoking cessation, pharmaceutical cessation aid use, and success in cessation in the general California population.Design, Setting, and Participants The large population-based California Tobacco Surveys of 1992, 1996, and 1999, including 5247 (71.3% response rate), 9725 (72.9% response rate), and 6412 (68.4% response rate) respondents, respectively.Main Outcome Measures Rates of cessation attempts ( greater than or equal to1 day) among smokers in the last year, use of pharmaceutical aids (mostly over-the-counter products since 1996), and cessation success.Results Between 1992 and 1999, cessation attempts among California smokers increased 61.4% (from 38.1% to 61.5%),and NRT use among quitters increased 50.5% (from 9.3% to 14.0%). A total of 17.2% of quitters used NRT, an antidepressant, or both as an aid to cessation in 1999. In 1996 and 1999, the median duration of aid use (14 days) was much less than recommended, and only about 20% of users had adjuvant one-on-one or group behavioral counseling. Use of NRT increased short-term cessation success in moderate to heavy smokers in each survey year. However, a long-term cessation advantage was only observed before NRT became widely available over-the-counter (August 1996). In 1999, no advantage for pharmaceutical aid users was observed in either the short or long term for the nearly 60% of California smokers classified as light smokers (