Harris Kari Jo, Okuyemi Kolawole S, Catley Delwyn, Mayo Matthew S, Ge Bin, Ahluwalia Jasjit S
Department of Psychology, University of Montana, Missoula, MT 59812, USA.
Prev Med. 2004 Apr;38(4):498-502. doi: 10.1016/j.ypmed.2003.12.008.
Identification of individual characteristics that predict successful smoking cessation treatment has been limited to studies with mostly white participants. This study identifies factors that predict successful quitting among African-Americans participating in a smoking cessation trial.
Twenty-one baseline variables were analyzed as potential predictors from a double-blind placebo-controlled, randomized trial that used bupropion SR for smoking cessation among 600 African-American smokers. Chi-square tests, two sample t tests, and multiple logistic regression procedures were employed to identify predictors of 7-day abstinence among the 535 participants who completed the 7-week medication phase.
Univariate predictors of cessation were receiving bupropion (P < 0.0001), not smoking menthol cigarettes (P = 0.0062), smoking after 30 min of waking (P < 0.0001), older age (P = 0.0085), smoking fewer cigarettes per day (P = 0.0038), and lower cotinine levels (P = 0.0002). Logistic regression identified three significant independent predictors. Participants who received bupropion treatment were more than twice as likely to quit smoking at the end of treatment compared to participants who received placebo (OR = 2.62; 95% CI = 1.77-3.88, P < 0.0001), while smoking within 30 min of waking (OR = 0.40; 95% CI = 0.25-0.62, P < 0.0001) and higher salivary cotinine levels at baseline (OR = 0.799; 95% CI = 0.629-0.922, P < 0.0001) reduced the likelihood of quitting.
This is the first report identifying predictors of smoking cessation among African-Americans participating in a clinical trial. Results indicate that, aside from bupropion treatment, various indicators of addiction were the strongest predictors. While this is similar to findings among white smokers, thresholds of addiction may need to be adjusted for African-American smoking patterns. Additional studies focused on diverse populations are needed to improve treatment approaches and to identify population-specific factors that are important for treatment-matching approaches.
识别预测戒烟治疗成功的个体特征的研究，大多局限于以白人为主要参与者的试验。本研究旨在确定参与戒烟试验的非裔美国人中预测成功戒烟的因素。
在一项双盲安慰剂对照随机试验中，对600名非裔美国吸烟者使用安非他酮缓释片进行戒烟，分析21个基线变量作为潜在预测因素。对完成7周药物治疗阶段的535名参与者，采用卡方检验、两样本t检验和多重逻辑回归程序来确定7天戒烟的预测因素。
戒烟的单因素预测因素包括服用安非他酮（P < 0.0001）、不吸薄荷醇香烟（P = 0.0062）、醒来30分钟后吸烟（P < 0.0001）、年龄较大（P = 0.0085）、每天吸烟较少（P = 0.0038）和可替宁水平较低（P = 0.0002）。逻辑回归确定了三个显著的独立预测因素。与接受安慰剂的参与者相比，接受安非他酮治疗的参与者在治疗结束时戒烟的可能性高出两倍多（比值比 = 2.62；95%置信区间 = 1.77 - 3.88，P < 0.0001），而醒来后30分钟内吸烟（比值比 = 0.40；95%置信区间 = 0.25 - 0.62，P < 0.000）和基线时唾液可替宁水平较高（比值比 = 0.799；95%置信区间 = 0.629 - 0.922，P < 0.0001）会降低戒烟的可能性。
这是第一份关于参与临床试验的非裔美国人戒烟预测因素的报告。结果表明，除了安非他酮治疗外，各种成瘾指标是最强的预测因素。虽然这与白人吸烟者的研究结果相似，但对于非裔美国人的吸烟模式，成瘾阈值可能需要调整。需要针对不同人群开展更多研究，以改进治疗方法，并确定对治疗匹配方法重要的特定人群因素。
