Extended Self-Help for Smoking Cessation: A Randomized Controlled Trial.
Extended Self-Help for Smoking Cessation: A Randomized Controlled Trial.
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DOI：
10.1016/j.amepre.2015.12.016
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发表时间：
2016-07
影响因子：
5.5
通讯作者：
Meltzer LR
中科院分区：
文献类型：
--
作者：
Brandon TH;Simmons VN;Sutton SK;Unrod M;Harrell PT;Meade CD;Craig BM;Lee JH;Meltzer LR
很少有吸烟者在他们的医疗保健访问中接受推荐的干预措施，这突出了确定有效，低成本的吸烟干预措施的重要性。自助干预（例如，书面材料）可以满足这一需要，但效果不佳。这项随机对照试验的目的是确定增加持续时间和强度的自助干预的有效性。随机平行试验设计，包括2010年4月至2011年8月期间的入组，随访数据为24个月。美国每日吸烟者的国家样本（N= 1，874）。参与者被随机分配到平行试验设计的三个组中的一个：传统自助（TSH，n=638），标准重复邮寄（SRM，n=614）或密集重复邮寄（SRM，n=622）。TSH收到了现有的戒烟自助小册子。SRM在12个月内收到了8份不同的戒烟手册。在18个月的时间里，儿童基金会每月收到10份旨在加强社会支助的小册子和其他材料。主要结局是在6、12、18和24个月时收集的7天点患病率禁欲。分析了2013年至2015年的数据。在所有四个随访时间点均发现了剂量反应效应。例如，到24个月时，母乳喂养产生的禁欲率最高（30.0%），其次是SRM（24.4%）和TSH（18.9%）。促甲状腺激素组与促甲状腺激素组24个月戒断率的差异为11.0%（95%CI = 5.7%，16.3%）。成本分析表明，与促甲状腺激素相比，接受SRM和ESTA的每名戒烟者的增量成本分别为560美元和361美元。自助干预的强度和持续时间增加，导致显着提高禁欲率，延长6个月后的干预结束。尽管强度更大，但干预措施具有很高的成本效益，这表明在医疗机构中广泛传播可以大大提高戒烟率。本研究注册于ClinicalTrials.gov（NCT 01352195）。
Far too few smokers receive recommended interventions at their healthcare visits, highlighting the importance of identifying effective, low-cost smoking interventions that can be readily delivered. Self-help interventions (e.g., written materials) would meet this need, but they have shown low efficacy. The purpose of this RCT was to determine the efficacy of a self-help intervention with increased duration and intensity. Randomized parallel trial design involving enrollment between April 2010 and August 2011 with follow-up data for 24 months. U.S. national sample of daily smokers (N=1,874). Participants were randomized to one of three arms of a parallel trial design: Traditional Self-Help (TSH, n=638), Standard Repeated Mailings (SRM, n=614), or Intensive Repeated Mailings (IRM, n=622). TSH received an existing self-help booklet for quitting smoking. SRM received eight different cessation booklets mailed over a 12-month period. IRM received monthly mailings of ten booklets and additional material designed to enhance social support over 18 months. The primary outcome was 7-day point-prevalence abstinence collected at 6, 12, 18, and 24 months. Data were analyzed between 2013 and 2015. A dose–response effect was found across all four follow-up points. For example, by 24 months, IRM produced the highest abstinence rate (30.0%), followed by SRM (24.4%), and TSH (18.9%). The difference in 24-month abstinence rates between IRM and TSH was 11.0% (95% CI=5.7%, 16.3%). Cost analyses indicated that, compared with TSH, the incremental cost per quitter who received SRM and IRM was $560 and $361, respectively. Self-help interventions with increased intensity and duration resulted in significantly improved abstinence rates that extended 6 months beyond the end of the intervention. Despite the greater intensity, the interventions were highly cost effective, suggesting that widespread dissemination in healthcare settings could greatly enhance quitting. This study is registered with ClinicalTrials.gov (NCT01352195).