Carpenter Matthew J, Hughes John R, Gray Kevin M, Wahlquist Amy E, Saladin Michael E, Alberg Anthony J
Department of Psychiatry, Hollings Cancer Center, Medical University of South Carolina, Charleston, 29425, USA.
Arch Intern Med. 2011 Nov 28;171(21):1901-7. doi: 10.1001/archinternmed.2011.492.
Rates of smoking cessation have not changed in a decade, accentuating the need for novel approaches to prompt quit attempts.
Within a nationwide randomized clinical trial (N = 849) to induce further quit attempts and cessation, smokers currently unmotivated to quit were randomized to a practice quit attempt (PQA) alone or to nicotine replacement therapy (hereafter referred to as nicotine therapy), sampling within the context of a PQA. Following a 6-week intervention period, participants were followed up for 6 months to assess outcomes. The PQA intervention was designed to increase motivation, confidence, and coping skills. The combination of a PQA plus nicotine therapy sampling added samples of nicotine lozenges to enhance attitudes toward pharmacotherapy and to promote the use of additional cessation resources. Primary outcomes included the incidence of any ever occurring self-defined quit attempt and 24-hour quit attempt. Secondary measures included 7-day point prevalence abstinence at any time during the study (ie, floating abstinence) and at the final follow-up assessment.
Compared with PQA intervention, nicotine therapy sampling was associated with a significantly higher incidence of any quit attempt (49% vs 40%; relative risk [RR], 1.2; 95% CI, 1.1-1.4) and any 24-hour quit attempt (43% vs 34%; 1.3; 1.1-1.5). Nicotine therapy sampling was marginally more likely to promote floating abstinence (19% vs 15%; RR, 1.3; 95% CI, 1.0-1.7); 6-month point prevalence abstinence rates were no different between groups (16% vs 14%; 1.2; 0.9-1.6).
Nicotine therapy sampling during a PQA represents a novel strategy to motivate smokers to make a quit attempt.
clinicaltrials.gov Identifier: NCT00706979.
戒烟率在十年间未发生变化，这凸显了采用新方法促使人们尝试戒烟的必要性。
在一项全国性随机临床试验（N = 849）中，为促使更多人尝试戒烟并实现戒烟，将目前没有戒烟意愿的吸烟者随机分为仅接受模拟戒烟尝试（PQA）组或接受尼古丁替代疗法（以下简称尼古丁疗法）组，后者在模拟戒烟尝试的背景下进行抽样。经过为期6周的干预期后，对参与者进行6个月的随访以评估结果。模拟戒烟尝试干预旨在增强动机、信心和应对技巧。模拟戒烟尝试加尼古丁疗法抽样的组合增加了尼古丁含片样本，以改善对药物治疗的态度并促进使用其他戒烟资源。主要结局包括任何一次自行定义的戒烟尝试的发生率以及24小时戒烟尝试。次要指标包括研究期间任何时间的7天点患病率戒烟率（即浮动戒烟率）以及最终随访评估时的戒烟率。
与模拟戒烟尝试干预相比，尼古丁疗法抽样与任何戒烟尝试的发生率显著更高相关（49%对40%；相对风险[RR]，1.2；95%置信区间[CI]，1.1 - 1.4）以及任何24小时戒烟尝试的发生率显著更高相关（43%对34%；1.3；1.1 - 1.5）。尼古丁疗法抽样略微更有可能促进浮动戒烟（19%对15%；RR，1.3；95% CI，1.0 - 1.7）；两组间6个月的点患病率戒烟率无差异（16%对14%；1.2；0.9 - 1.6）。
在模拟戒烟尝试期间进行尼古丁疗法抽样是一种促使吸烟者尝试戒烟的新策略。
clinicaltrials.gov标识符：NCT00706979。
