Sussman Steve, Sun Ping, Dent Clyde W
Department of Psychology, Institute for Health Promotion and Disease Prevention Research, University of Southern California, Alhambra, CA 91803, USA.
Health Psychol. 2006 Sep;25(5):549-57. doi: 10.1037/0278-6133.25.5.549.
This article presents a meta-analysis of 48 teen cigarette smoking cessation studies, the 1st meta-analysis of its kind. The authors conducted searches of electronic databases and unpublished manuscripts from 1970 to 2003. Fifty contextual elements were coded from each article. A weighted least squares random effects method was used to pool results from individual study net effects estimates. Multilevel random coefficients modeling was applied to control for the intrastudy variation.
The primary outcome for the present analysis was quit rate. Data were entered as intent-to-treat (ITT) quit rates (not compliance sample rates). Overall treatment effect size and treatment effect sizes as a function of program content, modality, number of sessions, and length of follow-up were examined.
Across studies, program conditions, compared with control conditions, appeared to give smokers a 2.90% (95% confidence interval = 1.47-4.35%) absolute advantage in quitting, increasing the probability of quitting by approximately 46% (9.14% vs. 6.24%). Relatively higher quit rates were found in programs that included a motivation enhancement component, cognitive-behavioral techniques, and social influence approaches. Also, relatively higher quit rates were found in school-based clinic and classroom modalities. Furthermore, relatively higher quit rates were found for programs consisting of at least 5 quit sessions. Data also indicated that the effects were maintained at short-term (1 year or less) and longer term (longer than 1 year) follow-ups.
Much more teen smoking cessation research is needed, but teen smoking cessation programming is effective, and the present study provides a framework to move forward.
本文对48项青少年戒烟研究进行了荟萃分析,这是同类研究中的首次荟萃分析。作者检索了1970年至2003年的电子数据库和未发表的手稿。从每篇文章中提取了50个背景因素进行编码。采用加权最小二乘随机效应方法汇总各研究的净效应估计结果。应用多水平随机系数模型来控制研究内的变异。
本次分析的主要结局是戒烟率。数据以意向性分析(ITT)戒烟率(而非依从性样本率)录入。研究了总体治疗效应大小以及作为项目内容、方式、疗程数和随访时间函数的治疗效应大小。
在各项研究中,与对照条件相比,项目条件似乎使吸烟者在戒烟方面具有2.90%(95%置信区间=1.47 - 4.35%)的绝对优势,将戒烟概率提高了约46%(9.14%对6.24%)。在包含动机增强成分、认知行为技术和社会影响方法的项目中发现相对较高的戒烟率。此外,在学校诊所和课堂方式中也发现相对较高的戒烟率。此外,由至少5次戒烟疗程组成的项目的戒烟率相对较高。数据还表明,在短期(1年或更短)和长期(超过1年)随访中效果得以维持。
需要更多的青少年戒烟研究,但青少年戒烟项目是有效的,本研究提供了一个向前推进的框架。