Aimer Pip, Treharne Gareth J, Stebbings Simon, Frampton Chris, Cameron Vicky, Kirby Sandra, Stamp Lisa K
University of Otago, Christchurch, New Zealand.
University of Otago, Dunedin, New Zealand.
Arthritis Care Res (Hoboken). 2017 Jan;69(1):28-37. doi: 10.1002/acr.22960. Epub 2016 Nov 16.
Smoking adversely influences comorbidities in rheumatoid arthritis (RA). The aim of this pilot study was to investigate whether smoking cessation is increased following a 3-month smoking cessation intervention tailored for people with RA.
Thirty-nine current smokers with RA were recruited. Participants were randomized into the control group to receive the current local standard of care for smoking cessation (i.e., ABC = brief advice and subsidized nicotine replacement therapy [NRT], or into the intervention group to receive ABC plus additional smoking cessation advice for 3 months (ABC+), including face-to-face, telephone, and e-mail contact. Advice was tailored to the participants' specific needs from a range of intervention tools focused on education about smoking and RA, pain control, exercise, coping, and support. The primary outcome was smoking cessation at 6 months. The secondary outcome was sustained reduction in smoking at 6 months. Disease and psychosocial characteristics of quitters and nonquitters were examined.
The overall smoking cessation rate was 24%. There was no significant difference in smoking cessation rates between the ABC and ABC+ groups (21% versus 26%; P = 0.70). The mean number of cigarettes smoked daily was reduced by 44% (P < 0.001) but did not differ between ABC and ABC+ groups (mean reduction 47% versus 41%; P = 0.72). Successful quitters had more years in education and had smoked less across their lifetime, but these differences were not statistically significant.
Smoking cessation in RA may lead to a reduced comorbid burden. The lack of added benefit of the tailored intervention suggests that brief advice and NRT are currently the best practice for supporting people with RA who wish to quit smoking.
吸烟会对类风湿关节炎（RA）的合并症产生不利影响。这项初步研究的目的是调查针对类风湿关节炎患者量身定制的3个月戒烟干预措施是否能提高戒烟率。
招募了39名目前仍在吸烟的类风湿关节炎患者。参与者被随机分为对照组，接受当地现行的戒烟标准护理（即ABC =简短建议和补贴尼古丁替代疗法[NRT]），或分为干预组，接受ABC加上额外的3个月戒烟建议（ABC +），包括面对面、电话和电子邮件联系。建议是根据参与者的特定需求，从一系列干预工具中量身定制的，这些工具侧重于吸烟与类风湿关节炎的教育、疼痛控制、运动、应对和支持。主要结局是6个月时戒烟。次要结局是6个月时持续减少吸烟量。对戒烟者和未戒烟者的疾病及社会心理特征进行了检查。
总体戒烟率为24%。ABC组和ABC +组的戒烟率无显著差异（21%对26%；P = 0.70）。每日吸烟的平均数量减少了44%（P < 0.001），但ABC组和ABC +组之间没有差异（平均减少47%对41%；P = 0.72）。成功戒烟者受教育年限更长，一生吸烟量更少，但这些差异无统计学意义。
类风湿关节炎患者戒烟可能会减轻合并症负担。量身定制的干预措施缺乏额外益处表明，目前简短建议和尼古丁替代疗法是支持希望戒烟的类风湿关节炎患者的最佳做法。
