Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC;
Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL;
Nicotine Tob Res. 2014 Jul;16(7):992-9. doi: 10.1093/ntr/ntu025. Epub 2014 Mar 7.
Although the majority of smokers are ambivalent about quitting, few treatments specifically target smokers lacking motivation to quit in the near future. Most existing interventions are instead predicated on the belief that active treatments should only be distributed to smokers interested in quitting, a largely untested assumption.
In the current clinical trial (N = 157), motivated smokers wanting to quit in the next 30 days were given a 2-week nicotine replacement therapy (NRT) sample and a referral to a quitline (Group MNQ), while unmotivated smokers were randomized to receive the same treatment (Group UNQ) or a quitline referral only (Group UQ). Participants were tracked via telephone for 3 months to assess quitting behaviors and smoking reduction.
Groups significantly differed across all comparisons with regard to incidence of any quit attempt (MNQ: 77%, UNQ: 40%, UQ: 18%, p < .05) and any 24-hr quit attempts (62%, 32%, 16%, p < .05). Clinically meaningful differences emerged in the rates of floating (19%, 17%, 6%) and point prevalence abstinence (17%, 15%, 5%). Compared to participants in Group UQ (11%), a greater proportion of participants in Group MNQ (48%, p = .01) and Group UNQ (31%, p = .01) reduced their daily cigarette consumption by at least half. Proxy measures of cessation readiness (e.g., motivation) favored participants receiving active forms of treatment.
Providing NRT samples engaged both motivated and unmotivated smokers into the quitting process and produced positive changes in smoking outcomes. This suggests that motivation should not be considered a necessary precondition to receiving treatment.
尽管大多数吸烟者对戒烟持矛盾态度，但很少有治疗方法专门针对近期内缺乏戒烟动机的吸烟者。大多数现有的干预措施都是基于这样一种信念，即只有对戒烟感兴趣的吸烟者才应该接受积极的治疗，这一假设基本上未经检验。
在目前的临床试验中（N=157），有戒烟意愿且希望在接下来 30 天内戒烟的吸烟者接受了为期 2 周的尼古丁替代疗法（NRT）样本和戒烟热线转介（MNQ 组），而缺乏戒烟动机的吸烟者则随机分为接受相同治疗（UNQ 组）或仅接受戒烟热线转介（UQ 组）。通过电话对参与者进行了 3 个月的跟踪，以评估戒烟行为和吸烟量减少情况。
在所有比较中，MNQ 组在任何戒烟尝试的发生率（77%）、任何 24 小时戒烟尝试的发生率（62%）以及任何 7 天戒烟尝试的发生率（59%）方面均显著高于 UNQ 组和 UQ 组（分别为 40%、32%和 18%，p<.05）和任何 24 小时戒烟尝试的发生率（62%、32%、16%，p<.05）。在浮动戒烟率（19%、17%、6%）和点患病率戒烟率（17%、15%、5%）方面也出现了有临床意义的差异。与 UQ 组（11%）相比，MNQ 组（48%，p=0.01）和 UNQ 组（31%，p=0.01）中有更多的参与者减少了至少一半的每日吸烟量。停止准备的代理措施（如动机）有利于接受积极治疗的参与者。
提供 NRT 样本可以让有戒烟意愿和无戒烟意愿的吸烟者参与戒烟过程，并对吸烟结果产生积极影响。这表明，动机不应被视为接受治疗的必要前提。
