Pacific Institute for Research and Evaluation, University of Baltimore, Calverton, Maryland 20705, USA.
Am J Prev Med. 2010 Mar;38(3 Suppl):S364-72. doi: 10.1016/j.amepre.2009.11.016.
Smoking-cessation treatment policies could yield substantial increases in adult quit rates in the U.S.
The goals of this paper are to model the effects of individual cessation treatment policies on population quit rates, and to illustrate the potential benefits of combining policies to leverage their synergistic effects.
A mathematical model is updated to examine the impact of five cessation treatment policies on quit attempts, treatment use, and treatment effectiveness. Policies include: (1) expand cessation treatment coverage and provider reimbursement; (2) mandate adequate funding for the use and promotion of evidence-based, state-sponsored telephone quitlines; (3) support healthcare system changes to prompt, guide, and incentivize tobacco treatment; (4) support and promote evidence-based treatment via the Internet; and (5) improve individually tailored, stepped-care approaches and the long-term effectiveness of evidence-based treatments.
The annual baseline population quit rate is 4.3% of all current smokers. Implementing any policy in isolation is projected to increase the quit rate to between 4.5% and 6%. By implementing all five policies in combination, the quit rate is projected to increase to 10.9%, or 2.5 times the baseline rate.
If fully implemented in a coordinated fashion, cessation treatment policies could reduce smoking prevalence from its current rate of 20.5% to 17.2% within 1 year. By modeling the policy impacts on the components of the population quit rate (quit attempts, treatment use, treatment effectiveness), key indicators are identified that need to be analyzed in attempts to improve the effect of cessation treatment policies.
在美国,戒烟治疗政策可能会大幅提高成年人的戒烟率。
本文旨在通过建模来研究个别戒烟治疗政策对人群戒烟率的影响,并展示结合政策以发挥协同作用的潜在益处。
更新数学模型以评估五项戒烟治疗政策对戒烟尝试、治疗使用和治疗效果的影响。这些政策包括:(1)扩大戒烟治疗的覆盖范围和提供者报销;(2)强制规定充足的资金用于使用和推广基于证据的州立电话戒烟热线;(3)支持医疗保健系统的变革,以促使、指导和激励烟草治疗;(4)支持和推广基于证据的互联网治疗;(5)改进个性化、分级护理方法和基于证据的治疗的长期效果。
目前,所有吸烟者的年基线人群戒烟率为 4.3%。单独实施任何一项政策预计将使戒烟率提高到 4.5%至 6%之间。如果综合实施所有五项政策,预计戒烟率将提高到 10.9%,即基线率的 2.5 倍。
如果以协调的方式全面实施,戒烟治疗政策可以在一年内将吸烟率从目前的 20.5%降低到 17.2%。通过对人口戒烟率的组成部分(戒烟尝试、治疗使用、治疗效果)进行政策影响建模,确定了需要分析的关键指标,以努力提高戒烟治疗政策的效果。