Tobacco Cessation and Prevention Program, Boston, Massachusetts.
Tobacco Cessation and Prevention Program, Boston, Massachusetts.
Am J Prev Med. 2014 Oct;47(4):392-402. doi: 10.1016/j.amepre.2014.05.043.
The healthcare provider-referral quitline model has potential to help identify and connect more smokers to effective cessation services as compared to the self-referral model alone. However, research is limited as to whether provider-referred smokers, who may have more barriers to quitting, can have similar rates of quit success using traditional quitline interventions as self-referred smokers.
To (1) determine how provider-referred smokers may differ from self-referred smokers in their demographics, service utilization, and quit rates and (2) quantify the impact of traditional quitline services on provider-referred smokers' ability to quit.
Data were collected for 2,737 provider-referred and 530 self-referred Massachusetts quitline clients between November 2007 and February 2012. Analysis was performed in 2012. Wald chi-square tests and two-sample t-tests were used to identify differences between the two referral populations. A multivariable logistic regression model was used for each referral population, and smoker quit status at follow-up was the primary outcome. Tests and models were weighted using inverse probability of treatment weights propensity score weighting method.
Compared with self-referred smokers, provider-referred smokers were more likely to be non-white, less educated, and have public insurance. They were less ready to quit and had lower service utilization and quit rates. In both referral populations, clients who used services had greater odds of quitting than those who did not.
Expanding the provider-referral model may require quitlines to address the various risk factors associated with this population. Providers serve critical roles in preparing patients for quitline participation prior to referral.
与单纯的自我推荐模式相比，医疗服务提供者推荐的戒烟热线模式有望帮助更多的吸烟者识别并获得有效的戒烟服务。然而，对于那些可能面临更多戒烟障碍的被推荐吸烟者，他们是否可以通过传统的戒烟热线干预措施获得与自我推荐吸烟者相似的戒烟成功率，相关研究仍然有限。
（1）确定提供者推荐的吸烟者与自我推荐的吸烟者在人口统计学、服务利用和戒烟率方面可能存在哪些差异；（2）量化传统戒烟热线服务对提供者推荐的吸烟者戒烟能力的影响。
2012 年对 2007 年 11 月至 2012 年 2 月期间马萨诸塞州戒烟热线的 2737 名被推荐吸烟者和 530 名自我推荐吸烟者的数据进行了收集。采用 Wald chi-square 检验和两样本 t 检验来识别两种推荐人群之间的差异。对每个推荐人群使用多变量逻辑回归模型，以随访时的吸烟者戒烟状态为主要结局。测试和模型均采用逆概率治疗权重（inverse probability of treatment weights， IPTW）倾向评分加权法进行加权。
与自我推荐吸烟者相比，被推荐吸烟者更有可能是非裔美国人、受教育程度较低且拥有公共保险。他们戒烟的准备程度较低，服务利用率和戒烟率也较低。在这两种推荐人群中，使用服务的客户比未使用服务的客户戒烟的可能性更大。
扩展提供者推荐模式可能需要戒烟热线解决与该人群相关的各种风险因素。在推荐之前，提供者在为患者准备参与戒烟热线方面发挥着关键作用。
