Kotz Daniel, Brown Jamie, West Robert
Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands; Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
Addiction. 2014 Mar;109(3):491-9. doi: 10.1111/add.12429. Epub 2013 Dec 20.
There is a need for more evidence on the 'real-world' effectiveness of commonly used aids to smoking cessation from population-level studies. This study assessed the association between abstinence and use of different smoking cessation treatments after adjusting for key potential confounding factors.
Cross-sectional data from aggregated monthly waves of a household survey: the Smoking Toolkit Study.
England.
A total of 10 335 adults who smoked within the previous 12 months and had made at least one quit attempt during that time.
Participants were classified according to their use of cessation aids in their most recent quit attempt: (i) medication (nicotine replacement therapy, bupropion or varenicline) in combination with specialist behavioural support delivered by a National Health Service Stop Smoking Service; (ii) medication provided by the prescribing health-care professional without specialist behavioural support; (iii) nicotine replacement therapy (NRT) bought over the counter; and (iv) none of these. The main outcome measure was self-reported abstinence up to the time of the survey, adjusted for key potential confounders including tobacco dependence.
Compared with smokers using none of the cessation aids, the adjusted odds of remaining abstinent up to the time of the survey were 3.25 [95% confidence interval (CI) = 2.05-5.15] greater in users of prescription medication in combination with specialist behavioural support, 1.61 (95% CI = 1.33-1.94) greater in users of prescription medication combined with brief advice and 0.96 (95% CI = 0.81-1.13) in users of NRT bought over the counter.
After adjusting for major confounding variables such as tobacco dependence, smokers in England who use a combination of behavioural support and pharmacotherapy in their quit attempts have almost three times the odds of success than those who use neither pharmacotherapy nor behavioural support. Smokers who buy nicotine replacement therapy over the counter with no behavioural support have similar odds of success in stopping as those who stop without any aid.
需要从人群水平研究中获取更多关于常用戒烟辅助工具“现实世界”有效性的证据。本研究在调整关键潜在混杂因素后，评估了戒烟与使用不同戒烟治疗方法之间的关联。
来自家庭调查（吸烟工具包研究）每月汇总数据的横断面数据。
英国。
共有10335名在过去12个月内吸烟且在此期间至少尝试戒烟一次的成年人。
参与者根据其在最近一次戒烟尝试中使用戒烟辅助工具的情况进行分类：（i）药物治疗（尼古丁替代疗法、安非他酮或伐尼克兰）联合由英国国家医疗服务体系戒烟服务机构提供的专业行为支持；（ii）由开处方的医疗保健专业人员提供的药物治疗，但无专业行为支持；（iii）非处方购买的尼古丁替代疗法（NRT）；以及（iv）未使用上述任何一种方法。主要结局指标是在调查时自我报告的戒烟情况，并针对包括烟草依赖在内的关键潜在混杂因素进行了调整。
与未使用任何戒烟辅助工具的吸烟者相比，在调查时仍保持戒烟状态的调整后优势比在联合专业行为支持使用处方药的使用者中高3.25[95%置信区间（CI）=2.05 - 5.15]，在联合简短建议使用处方药的使用者中高1.61（95%CI = 1.33 - 1.94），在非处方购买NRT的使用者中为0.96（95%CI = 0.81 - 1.13）。
在调整了诸如烟草依赖等主要混杂变量后，在英国尝试戒烟时联合使用行为支持和药物治疗的吸烟者成功的几率几乎是既不使用药物治疗也不使用行为支持的吸烟者的三倍。在没有行为支持的情况下非处方购买尼古丁替代疗法的吸烟者与未借助任何帮助而戒烟的吸烟者成功戒烟的几率相似。
