Danaher Brian G, Severson Herbert H, Zhu Shu-Hong, Andrews Judy A, Cummins Sharon E, Lichtenstein Edward, Tedeschi Gary J, Hudkins Coleen, Widdop Chris, Crowley Ryann, Seeley John R
Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA.
Moores Cancer Center, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA USA.
Internet Interv. 2015 May 1;2(2):143-151. doi: 10.1016/j.invent.2015.02.005.
Use of smokeless tobacco (moist snuff and chewing tobacco) is a significant public health problem but smokeless tobacco users have few resources to help them quit. Web programs and telephone-based programs (Quitlines) have been shown to be effective for smoking cessation. We evaluate the effectiveness of a Web program, a Quitline, and the combination of the two for smokeless users recruited via the Web.
To test whether offering both a Web and Quitline intervention for smokeless tobacco users results in significantly better long-term tobacco abstinence outcomes than offering either intervention alone; to test whether the offer of Web or Quitline results in better outcome than a self-help manual only Control condition; and to report the usage and satisfaction of the interventions when offered alone or combined.
Smokeless tobacco users (N= 1,683) wanting to quit were recruited online and randomly offered one of four treatment conditions in a 2×2 design: Web Only, Quitline Only, Web + Quitline, and Control (printed self-help guide). Point-prevalence all tobacco abstinence was assessed at 3- and 6-months post enrollment.
69% of participants completed both the 3- and 6-month assessments. There was no significant additive or synergistic effect of combining the two interventions for Complete Case or the more rigorous Intent To Treat (ITT) analyses. Significant simple effects were detected, individually the interventions were more efficacious than the control in achieving repeated 7-day point prevalence all tobacco abstinence: Web (ITT, OR = 1.41, 95% CI = 1.03, 1.94, = ) and Quitline (ITT: OR = 1.54, 95% CI = 1.13, 2.11, = ). Participants were more likely to complete a Quitline call when offered only the Quitline intervention (OR = 0.71, 95% CI = .054, .093, = .013), the number of website visits and duration did not differ when offered alone or in combination with Quitline. Rates of program helpfulness ( <.05) and satisfaction ( <.05) were higher for those offered both interventions versus offered only quitline.
Combining Web and Quitline interventions did not result in additive or synergistic effects, as have been found for smoking. Both interventions were more effective than a self-help control condition in helping motivated smokeless tobacco users quit tobacco. Intervention usage and satisfaction were related to the amount intervention content offered. Usage of the Quitline intervention decreased when offered in combination, though rates of helpfulness and recommendations were higher when offered in combination.
Clinicaltrials.gov NCT00820495; http://clinicaltrials.gov/ct2/show/NCT00820495.
使用无烟烟草（湿鼻烟和嚼烟）是一个重大的公共卫生问题，但无烟烟草使用者几乎没有可帮助他们戒烟的资源。网络项目和基于电话的项目（戒烟热线）已被证明对戒烟有效。我们评估一个网络项目、一条戒烟热线以及二者结合对通过网络招募的无烟烟草使用者的有效性。
测试为无烟烟草使用者同时提供网络和戒烟热线干预是否比单独提供任何一种干预能带来显著更好的长期戒烟效果；测试提供网络或戒烟热线干预是否比仅提供自助手册的对照条件能带来更好的效果；并报告单独提供或联合提供干预措施时的使用情况和满意度。
想要戒烟的无烟烟草使用者（N = 1683）通过网络招募，并在2×2设计中随机分配到四种治疗条件之一：仅网络、仅戒烟热线、网络 + 戒烟热线以及对照（印刷版自助指南）。在入组后3个月和6个月评估所有烟草戒断的点患病率。
69%的参与者完成了3个月和6个月的评估。对于完全病例或更严格的意向性分析（ITT），两种干预措施结合没有显著的相加或协同效应。检测到显著的简单效应，单独来看，这些干预措施在实现连续7天的所有烟草戒断点患病率方面比对照组更有效：网络干预（ITT，OR = 1.41，95%CI = 1.03，1.94，P = ）和戒烟热线（ITT：OR = 1.54，95%CI = 1.13，2.11，P = ）。仅提供戒烟热线干预时，参与者更有可能完成一次戒烟热线通话（OR = 0.71，95%CI = 0.054，0.093，P = 0.0... ），单独提供或与戒烟热线联合提供时，网站访问次数和时长没有差异。对于同时提供两种干预措施的参与者，项目帮助性（P <.05）和满意度（P <.05）的评分高于仅提供戒烟热线的参与者。
与吸烟情况不同，网络和戒烟热线干预相结合并未产生相加或协同效应。在帮助有戒烟意愿的无烟烟草使用者戒烟方面，这两种干预措施都比自助对照条件更有效。干预措施的使用和满意度与提供的干预内容量有关。联合提供时，戒烟热线干预的使用率降低，不过联合提供时帮助性评分和推荐率更高。
Clinicaltrials.gov NCT00820495；http://clinicaltrials.gov/ct... （此处原文网址不完整）
