Centre for Health Research and Psycho-oncology (CHeRP), The Cancer Council NSW, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW, Australia.
Addiction. 2011 Sep;106(9):1568-85. doi: 10.1111/j.1360-0443.2011.03467.x. Epub 2011 Jul 22.
A systematic review and meta-analysis was conducted to assess the methodological quality and effectiveness of behavioural smoking cessation interventions targeted at six disadvantaged groups; the homeless, prisoners, indigenous populations, at-risk youth, individuals with low socio-economic status and individuals with a mental illness.
Medline, EMBASE, the Cochrane Library and PsycInfo databases were searched using MeSH and keywords for studies conducted in developed countries prior to October 2010. Included studies were assessed for methodological quality. A DerSimonian and Laird random effects meta-analysis was conducted where possible to explore the effectiveness of interventions for the different subgroups. A narrative review was conducted for studies unable to be included in the meta-analysis. Outcomes examined were abstinence rates at short-term (up to 3 months) and long-term (6 months or the longest) follow-up.
Thirty-two relevant studies were identified. The majority (n = 20) were rated low in methodological quality. Results of the meta-analysis showed a significant increase in cessation for behavioural support interventions targeted at low-income female smokers at short-term follow-up [relative risk (RR) 1.68, confidence interval (CI) 1.21-2.33], and behavioural support interventions targeted at individuals with a mental illness at long-term follow-up (RR 1.35, CI 1.01-1.81). Results of the narrative review showed several promising interventions that increased cessation rates at 6-month or longer follow-up.
Few well-controlled trials have examined the most effective smoking cessation strategies for highly disadvantaged groups, especially among the homeless, indigenous smokers and prisoners. The use of behavioural smoking cessation interventions for some socially disadvantaged groups appears promising; however, overall findings are inconsistent. Further research is needed to establish the most effective interventions for vulnerable high-risk groups. Special attention should be given to increasing sample size and power, and to sound evaluation methodology to overcome methodological limitations of conducting research with these high-risk groups.
系统评价和荟萃分析评估了针对六个弱势群体（无家可归者、囚犯、土著人口、高危青少年、社会经济地位低的个体和患有精神疾病的个体）的行为戒烟干预措施的方法学质量和效果。
在 2010 年 10 月之前，使用 Medline、EMBASE、Cochrane 图书馆和 PsycInfo 数据库，使用 MeSH 和关键词搜索了在发达国家进行的研究。对纳入的研究进行了方法学质量评估。如果可能，采用 DerSimonian 和 Laird 随机效应荟萃分析来探索不同亚组干预措施的有效性。对于无法纳入荟萃分析的研究，进行了叙述性综述。评估的结果是短期（最多 3 个月）和长期（6 个月或最长时间）随访时的戒烟率。
确定了 32 项相关研究。其中大多数（n=20）的方法学质量评分较低。荟萃分析的结果表明，短期随访时针对低收入女性吸烟者的行为支持干预措施显著增加了戒烟率[相对风险（RR）1.68，置信区间（CI）1.21-2.33]，以及长期随访时针对患有精神疾病的个体的行为支持干预措施[RR 1.35，CI 1.01-1.81]。叙述性综述的结果表明，一些有前途的干预措施可在 6 个月或更长时间的随访时增加戒烟率。
很少有经过良好对照的试验研究过最有效的针对高度弱势群体的戒烟策略，尤其是针对无家可归者、土著吸烟者和囚犯。对于某些社会弱势群体，使用行为戒烟干预措施似乎很有希望；但是，总体结果不一致。需要进一步研究以确定最有效的脆弱高危人群干预措施。特别应注意增加样本量和功率，并采用健全的评估方法，以克服对这些高危人群进行研究的方法学局限性。
