Toll Benjamin A, Martino Steve, O'Malley Stephanie S, Fucito Lisa M, McKee Sherry A, Kahler Christopher W, Rojewski Alana M, Mahoney Martin C, Wu Ran, Celestino Paula, Seshadri Srinivasa, Koutsky James, Hyland Andrew, Cummings K Michael
Department of Psychiatry.
Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare Center.
J Consult Clin Psychol. 2015 Jun;83(3):445-54. doi: 10.1037/a0038183. Epub 2014 Nov 24.
This study evaluated whether tobacco quitline telephone coaches can be trained to counsel hazardous-drinking smokers to improve smoking cessation success and to limit or abstain from alcohol use.
Smokers (N = 1,948) who called the New York State Smokers' Quitline and reported hazardous drinking (exceeding sex-specific weekly limits [14 drinks for men, 7 drinks for women] or meeting/exceeding daily drinking limits [5 drinks for men, 4 drinks for women] at least once in the past year) were randomized to receive either brief motivational counseling to limit or abstain from alcohol plus an alcohol reduction booklet added to standard care (Alcohol + Tobacco Counseling; ATC), or only smoking cessation counseling plus a smoking cessation booklet added to standard care (Tobacco-Only Counseling; TOC).
Acceptable coach adherence was achieved. The intention-to-treat (ITT) analysis showed that ATC was associated with a significantly higher rate of smoking abstinence at 7-month follow-up (13.5%) compared with TOC (10.3%; p = .03). The respondent analysis (ATC= 26.2%; TOC = 20.4%) paralleled the ITT findings. When controlling for treatment condition, participants who did not report any heavy drinking were significantly more likely to quit smoking than those who reported any heavy drinking (OR = 1.87, 95% CI [1.29, 2.71]; p = .001).
A brief alcohol intervention plus standard care via a telephone quitline resulted in significantly higher smoking cessation rates for hazardous-drinking callers. Given that quitline coaches were trained to provide the intervention with acceptable adherence, the potential to extend this intervention for wide-scale implementation and impact is promising.
本研究评估了是否可以对戒烟热线的电话辅导人员进行培训,以便为有危险饮酒行为的吸烟者提供咨询,从而提高戒烟成功率,并限制或戒除饮酒。
拨打纽约州戒烟热线并报告有危险饮酒行为(超过按性别划分的每周饮酒限量[男性14杯,女性7杯],或在过去一年中至少有一次达到/超过每日饮酒限量[男性5杯,女性4杯])的吸烟者(N = 1948)被随机分组,分别接受限制或戒除饮酒的简短动机咨询,并在标准护理基础上增加一本减少酒精摄入的手册(酒精+烟草咨询;ATC),或仅接受戒烟咨询,并在标准护理基础上增加一本戒烟手册(仅烟草咨询;TOC)。
辅导人员的依从性达到了可接受水平。意向性分析(ITT)表明,与TOC组(10.3%;p = 0.03)相比,ATC组在7个月随访时的戒烟率显著更高(13.5%)。应答者分析(ATC = 26.2%;TOC = 20.4%)与ITT结果一致。在控制治疗条件后,未报告有任何重度饮酒行为的参与者比报告有任何重度饮酒行为的参与者戒烟的可能性显著更高(OR = 1.87,95% CI [1.29, 2.71];p = 0.001)。
通过电话戒烟热线进行简短的酒精干预并结合标准护理,可使有危险饮酒行为的来电者的戒烟率显著提高。鉴于戒烟热线的辅导人员经过培训后能够以可接受的依从性提供干预措施,将这种干预措施推广到大规模实施并产生影响的潜力很大。