Myung Seung-Kwon, McDonnell Diana D, Kazinets Gene, Seo Hong Gwan, Moskowitz Joel M
Smoking Cessation Clinic, Center for Cancer Prevention and Detection, Division of Cancer Prevention, National Cancer Control Research Institute, National Cancer Center, Goyang, South Korea.
Arch Intern Med. 2009 May 25;169(10):929-37. doi: 10.1001/archinternmed.2009.109.
The effects of Web- and computer-based smoking cessation programs are inconsistent in randomized controlled trials (RCTs). We evaluated those effects using a meta-analysis.
We searched MEDLINE (PubMed), EMBASE, and the Cochrane Review in August 2008. Two evaluators independently selected and reviewed eligible studies.
Of 287 articles searched, 22 RCTs, which included 29 549 participants with 16 050 enrolled in Web- or computer-based smoking cessation program groups and 13 499 enrolled in control groups, were included in the final analyses. In a random-effects meta-analysis of all 22 trials, the intervention group had a significant effect on smoking cessation (relative risk [RR], 1.44; 95% confidence interval [CI], 1.27-1.64). Similar findings were observed in 9 trials using a Web-based intervention (RR, 1.40; 95% CI, 1.13-1.72) and in 13 trials using a computer-based intervention (RR, 1.48; 95% CI, 1.25-1.76). Subgroup analyses revealed similar findings for different levels of methodological rigor, stand-alone vs supplemental interventions, type of abstinence rates employed, and duration of follow-up period, but not for adolescent populations (RR, 1.08; 95% CI, 0.59-1.98).
The meta-analysis of RCTs indicates that there is sufficient clinical evidence to support the use of Web- and computer-based smoking cessation programs for adult smokers.
在随机对照试验(RCT)中,基于网络和计算机的戒烟项目的效果并不一致。我们通过荟萃分析评估了这些效果。
我们于2008年8月检索了MEDLINE(PubMed)、EMBASE和Cochrane系统评价。两名评估人员独立选择并审查符合条件的研究。
在检索的287篇文章中,最终分析纳入了22项随机对照试验,共29549名参与者,其中16050名参与基于网络或计算机的戒烟项目组,13499名参与对照组。在对所有22项试验的随机效应荟萃分析中,干预组对戒烟有显著效果(相对危险度[RR],1.44;95%置信区间[CI],1.27 - 1.64)。在9项使用基于网络干预的试验(RR,1.40;95% CI,1.13 - 1.72)和13项使用基于计算机干预的试验(RR,1.48;95% CI,1.25 - 1.76)中观察到类似结果。亚组分析显示,在方法学严谨程度、独立干预与补充干预、采用的戒断率类型以及随访期持续时间等不同水平上有类似结果,但在青少年人群中并非如此(RR,1.08;95% CI,0.59 - 1.98)。
随机对照试验的荟萃分析表明,有足够的临床证据支持将基于网络和计算机的戒烟项目用于成年吸烟者。