Lancaster Tim, Hajek Peter, Stead Lindsay F, West Robert, Jarvis Martin J
Department of Primary Health Care, University of Oxford, Headington, England.
Arch Intern Med. 2006 Apr 24;166(8):828-35. doi: 10.1001/archinte.166.8.828.
After initially successful quit attempts, many people return to smoking within a year, reducing the public health benefits of investment in smoking cessation. We aimed to assess whether interventions designed to prevent relapse after a successful quit attempt reduce the proportion of recent quitters who return to smoking.
We searched the Cochrane Tobacco Addiction Review Group trials' register. We selected randomized or quasi-randomized controlled trials of relapse prevention interventions with a minimum follow-up of 6 months. We included people who quit on their own, underwent enforced abstinence, or were in treatment programs. We included trials comparing relapse prevention interventions with no intervention or cessation plus relapse prevention with cessation intervention alone. Two of us independently extracted data from each report, with disagreements referred to a third author.
Forty-two studies met the inclusion criteria. The most common interventions were skills training to identify and resolve tempting situations and extended treatment contact. A few studies tested pharmacotherapy. We separately analyzed studies that randomized abstainers and those that randomized participants before their quit date. Within subgroups of trials, pooled odds ratios ranged from 0.86 to 1.30, and in most analyses, 95% confidence intervals included 1. Most studies had limited power to detect moderate differences between interventions.
The evidence to date does not support the adoption of skills training or other specific interventions to help individuals who have successfully quit smoking to avoid relapse, but this is an important area for future study.
在最初的戒烟尝试取得成功后，许多人在一年内又重新开始吸烟，这降低了戒烟投资所带来的公共卫生效益。我们旨在评估旨在防止成功戒烟后复吸的干预措施是否能降低近期戒烟者重新吸烟的比例。
我们检索了Cochrane烟草成瘾综述小组试验注册库。我们选择了预防复吸干预措施的随机或半随机对照试验，最短随访期为6个月。我们纳入了自行戒烟、强制戒烟或参加治疗项目的人群。我们纳入了比较预防复吸干预措施与无干预措施，或比较戒烟加预防复吸与单纯戒烟干预措施的试验。我们两人独立从每份报告中提取数据，如有分歧则提交给第三位作者。
42项研究符合纳入标准。最常见的干预措施是识别和解决诱发情境的技能培训以及延长治疗接触时间。少数研究测试了药物治疗。我们分别分析了将已戒烟者随机分组的研究以及在戒烟日期前将参与者随机分组的研究。在各试验亚组中，合并比值比范围为0.86至1.30，在大多数分析中，95%置信区间包含1。大多数研究检测干预措施之间中度差异的能力有限。
迄今为止的证据不支持采用技能培训或其他特定干预措施来帮助已成功戒烟的个体避免复吸，但这是未来研究的一个重要领域。
