Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), Via delle Oblate 2, Florence, 50141, Italy.
BMC Public Health. 2012 Sep 5;12:740. doi: 10.1186/1471-2458-12-740.
The organized Cervical Cancer Screening Programme (CCSP) in Italy might represent an occasion to deliver smoking cessation (SC) counselling to women attending the Pap test examination. Evidence of effectiveness of physical activity (PA) promotion and intervention in adjunct to SC counselling is not strong.Objective of the SPRINT trial was to evaluate the effectiveness of a standard SC counselling intervention delivered by trained midwives in the CCSP, and whether the adjunct of a PA counselling to the SC counselling might increase quit rates.
METHODS/DESIGN: We undertook a randomized controlled trial of 1,100 women undergoing the Pap examination in the three study centres Florence, Turin, and Mantua: 363 were randomly assigned to the SC counselling arm, 366 to the SC + PA counselling arm, and 371 to the control group. The intervention was a standard brief SC counselling combined with a brief counselling on increasing PA, and was tailored according to the Di Clemente-Prochaska motivational stages of change for SC and/or PA. Primary outcomes were quit rates, improvement in the motivational stages of change for SC, and reduced daily cigarette consumption. Analysis was by intention to treat.
Participants randomized in both intervention arms and in the preparation stage of change for SC doubled their likelihood of quitting at 6-month follow-up in comparison to controls (odds ratio [OR]=2.1, 95% confidence interval [95% CI]:1.0-4.6). Moreover, participants in the intervention arms and in the contemplation stage were more likely to reduce their daily cigarette consumption after the intervention (OR=1.8, 95% CI:1.1-3.0). Our study did not show any effect of PA counselling on various outcomes.
Smoking cessation counselling delivered by midwives to smokers in preparation and contemplation stages of change during the Pap-smear screening was effective and should be recommended, given the high number of women attending the cervical cancer screening programme in Italy. Moreover, the daily number of women invited for the Pap-smear examination should be slightly lowered, in order to let midwives deliver SC counselling to smokers.
Current Controlled Trials ISRCTN52660565.
意大利有组织的宫颈癌筛查计划（CCSP）可能为在接受巴氏涂片检查的女性提供戒烟（SC）咨询提供机会。目前尚无强有力的证据表明，在 SC 咨询的基础上增加身体活动（PA）促进和干预的有效性。
SPRINT 试验的目的是评估在 CCSP 中由经过培训的助产士提供的标准 SC 咨询干预的效果，以及在 SC 咨询的基础上增加 PA 咨询是否可以提高戒烟率。
方法/设计：我们在佛罗伦萨、都灵和曼图亚的三个研究中心进行了一项随机对照试验，共有 1100 名接受巴氏涂片检查的女性参与：363 名随机分配到 SC 咨询组，366 名分配到 SC+PA 咨询组，371 名分配到对照组。干预措施是标准的简短 SC 咨询，结合增加 PA 的简短咨询，并根据 SC 和/或 PA 的 Di Clemente-Prochaska 动机变化阶段进行定制。主要结局是戒烟率、SC 动机变化阶段的改善以及每日吸烟量的减少。分析采用意向治疗。
与对照组相比，随机分配到两个干预组和 SC 准备阶段变化的参与者在 6 个月随访时戒烟的可能性增加了一倍（优势比[OR]=2.1，95%置信区间[95%CI]：1.0-4.6）。此外，干预组和沉思阶段的参与者在干预后更有可能减少每日吸烟量（OR=1.8，95%CI：1.1-3.0）。我们的研究没有显示 PA 咨询对各种结果有任何影响。
在 Pap 涂片筛查期间，向处于准备和沉思阶段的吸烟者提供由助产士提供的戒烟咨询是有效的，并且应该被推荐，因为在意大利有大量的女性参加宫颈癌筛查计划。此外，应该稍微降低每天邀请接受 Pap 涂片检查的女性人数，以便让助产士为吸烟者提供 SC 咨询。
当前对照试验 ISRCTN52660565。
