Etter J F, Perneger T V
Institute of Social and Preventive Medicine, University of Geneva, CMU, case postale, CH-1211 Geneva 4, Switzerland.
Arch Intern Med. 2001 Nov 26;161(21):2596-601. doi: 10.1001/archinte.161.21.2596.
From a public health perspective, prevention of cancer and cardiovascular diseases requires effective smoking cessation programs that can be used on a large scale.
To test the effectiveness of a new computer-tailored smoking cessation program vs no intervention.
Randomized controlled trial, in the French-speaking part of Switzerland, September 20, 1998, to December 31, 1999. Potential participants were randomly selected from a general population register and recruited by mail. Daily cigarette smokers who wished to participate (N = 2934) were randomized to either the program or no intervention. A mean of 1.5 times per 6 months, participants in the active arm received by mail a computer-tailored counseling letter based on their answers to a questionnaire and stage-matched booklets. The counseling letters were tailored to the participants' stage of change (categorized as precontemplation [no intention of quitting smoking in the next 6 months], contemplation [seriously considers quitting in the next 6 months], or preparation [has decided to quit in the next 30 days]), level of tobacco dependence, self-efficacy, and personal characteristics. The outcome measure was self-reported abstinence (no puff of tobacco smoke in the past 4 weeks) 7 months after entry into the program.
Abstinence was 2.6 times greater in the intervention group than in the control group (5.8% vs 2.2%, P<.001). The program was effective in "precontemplators" who were not motivated to quit smoking at baseline (intervention vs control, 3.8% vs 0.8%; P =.001) and was effective regardless of perceived difficulty in quitting smoking at baseline.
The program was effective in increasing smoking cessation rates. Because it can reach a large number of smokers, this program can substantially contribute to disease prevention at a population level.
从公共卫生角度来看，预防癌症和心血管疾病需要有效的戒烟项目，以便能大规模应用。
测试一种新的计算机定制戒烟项目与无干预措施相比的有效性。
1998年9月20日至1999年12月31日在瑞士法语区进行的随机对照试验。潜在参与者从总人口登记册中随机选取，并通过邮件招募。希望参与的每日吸烟者（N = 2934）被随机分为接受该项目组或无干预组。积极干预组的参与者每6个月平均收到1.5次通过邮件发送的基于其对问卷回答及阶段匹配手册的计算机定制咨询信。咨询信根据参与者的改变阶段（分为未考虑阶段[未来6个月内无意戒烟]、考虑阶段[认真考虑在未来6个月内戒烟]或准备阶段[已决定在未来30天内戒烟]）、烟草依赖程度、自我效能感和个人特征进行定制。结局指标为进入项目7个月后自我报告的戒烟情况（过去4周内未吸一口烟草烟雾）。
干预组的戒烟率比对照组高2.6倍（5.8%对2.2%，P <.001）。该项目对基线时无戒烟动机的“未考虑者”有效（干预组与对照组，3.8%对0.8%；P =.001），且无论基线时感知的戒烟难度如何均有效。
该项目在提高戒烟率方面有效。由于它能覆盖大量吸烟者，该项目可在人群层面为疾病预防做出重大贡献。
