McAfee Timothy A, Bush Terry, Deprey T Mona, Mahoney Lisa D, Zbikowski Susan M, Fellows Jeffrey L, McClure Jennifer B
Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.
Am J Prev Med. 2008 Aug;35(2):103-10. doi: 10.1016/j.amepre.2008.04.017.
State-level tobacco quitlines are integrating nicotine replacement therapy (NRT) into service. Because of funding limitations some provide short courses of NRT. No randomized trial has evaluated the relative benefit of short versus standard treatment.
A two-cell randomized trial comparing 2 weeks of NRT to 8 weeks.
SETTING/PARTICIPANTS: Uninsured callers to the Oregon Quit Line during a free-patch initiative from October 18, 2004, to May 5, 2005, who were 18 years or older, smoked five or more cigarettes per day, did not have a medical contraindication to NRT use, and were interested in quitting in 30 days. Data were collected from April to November 2005, and analyzed in 2006--2007.
Participants were eligible for two phone counseling sessions. 1154 participants were randomized to receive via the mail either 2 or 8 weeks of nicotine patches.
Primary outcome was self-reported complete abstinence from tobacco for 30 or more days at the 6-month phone survey. Secondary outcomes were 7-day point prevalence and 90-day abstinence, satisfaction, and patch use. ORs and CIs were computed. Cost per quit and incremental cost per additional quit were computed based on program costs.
Intent-to-treat 30-day abstinence was 14.3% in the 2-week group, and 19.6% in the 8-week group (OR 1.45 [CI=1.01, 2.12]). Average cost per quit was $1156 for 2 weeks and $1405 for 8 weeks, with an incremental cost effectiveness of $2068. Satisfaction increased from 90% to 97% with 8 weeks. Those receiving 8 weeks of NRT took more calls (2.0 vs 1.6) and used more patches (6.3 weeks vs 4.3 weeks), but were less likely to purchase patches (16.2% vs 39.3%).
Eight weeks of patches improved quit rates compared with 2 weeks, and was cost effective.
州级戒烟热线正在将尼古丁替代疗法（NRT）纳入服务。由于资金限制，一些戒烟热线提供短期的NRT疗程。尚无随机试验评估短期治疗与标准治疗的相对益处。
一项双组随机试验，比较2周NRT与8周NRT。
设置/参与者：2004年10月18日至2005年5月5日俄勒冈戒烟热线在免费贴片活动期间接到的无保险来电者，年龄在18岁及以上，每天吸烟5支或更多，无NRT使用的医学禁忌，且有意在30天内戒烟。数据于2005年4月至11月收集，并于2006 - 2007年进行分析。
参与者有资格接受两次电话咨询。1154名参与者被随机分组，通过邮件接受2周或8周的尼古丁贴片。
主要结局是在6个月电话调查时自我报告连续30天或更长时间完全戒烟。次要结局包括7天点患病率、90天戒烟率、满意度和贴片使用情况。计算比值比（OR）和置信区间（CI）。根据项目成本计算每成功戒烟一人的成本以及每多成功戒烟一人的增量成本。
意向性分析显示，2周组30天戒烟率为14.3%，8周组为19.6%（OR 1.45 [CI = 1.01, 2.12]）。2周疗程每成功戒烟一人的平均成本为1156美元，8周疗程为1405美元，增量成本效果为2068美元。8周疗程的满意度从90%提高到97%。接受8周NRT的参与者接听电话更多（2.0次对1.6次），使用贴片更多（6.3周对4.3周），但购买贴片的可能性更小（16.2%对39.3%）。
与2周相比，8周的贴片治疗提高了戒烟率，且具有成本效益。
