Meyer Christian, Ulbricht Sabina, Haug Severin, Broda Anja, Bischof Gallus, Rumpf Hans-Jürgen, John Ulrich
Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany; Partner site Greifswald, DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.
Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany; Partner site Greifswald, DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.
Drug Alcohol Depend. 2016 Sep 1;166:177-86. doi: 10.1016/j.drugalcdep.2016.07.009. Epub 2016 Jul 15.
This study examined the long-term efficacy of individualized counseling letters that targeted either smoking abstinence or reducing the number of cigarettes smoked per day to promote future cessation.
A nationwide random-digit-dialing telephone sample was used to identify smokers from the general adult population (participation proportion: 54.5%). In total, 1462 participants (48% female) who did not intend to quit within the next six months and who smoked ten or more cigarettes a day were randomized to one of two intervention groups or an assessment-only control condition. The interventions consisted of three tailored letters that were sent after baseline and follow-up assessments after three and six months. Follow-up data on smoking status were provided by 82% and 77% of the participants 12 and 24 months after study inclusion, respectively. Generalized estimation equation (GEE) models adjusted for potential baseline confounders and multiple imputation of missing follow-up data were used to estimate intervention effects.
At 24-month follow-up prevalence of 7-day point abstinence was 8.4%, 12.9% and 14.7% in the control, abstinence intervention and reduction intervention condition, which corresponds to a number needed to treat of 22 (95%-CI: 11-707) and 16 (95%-CI: 9-53). Adjusted GEE analyses revealed that the smoking reduction intervention (ORadj=2.3, p<0.01) but not the abstinence intervention (ORadj=1.4, p=0.20) increased the odds of 6-month prolonged abstinence compared with the control condition. No significant differences appear when directly comparing both intervention groups.
Smoking reduction should be considered as an alternative intervention goal for smokers who are unable or unwilling to quit.
本研究探讨了针对戒烟或减少每日吸烟量的个性化咨询信件在促进未来戒烟方面的长期效果。
采用全国范围内随机数字拨号电话抽样的方式，从一般成年人群中识别吸烟者（参与比例：54.5%）。共有1462名参与者（48%为女性），他们在接下来的六个月内无意戒烟且每天吸烟十支或更多，被随机分配到两个干预组之一或仅进行评估的对照条件组。干预措施包括在基线以及三个月和六个月后的随访评估后发送的三封量身定制的信件。分别有82%和77%的参与者在纳入研究后12个月和24个月提供了吸烟状况的随访数据。使用针对潜在基线混杂因素进行调整的广义估计方程（GEE）模型以及对缺失随访数据进行多重插补的方法来估计干预效果。
在24个月的随访中，对照组、戒烟干预组和减少吸烟量干预组的7天点戒烟率分别为8.4%、12.9%和14.7%，相应的治疗所需人数分别为22（95%置信区间：11 - 707）和16（95%置信区间：9 - 53）。经调整的GEE分析显示，与对照条件相比，减少吸烟量干预（调整后比值比=2.3，p<0.01）而非戒烟干预（调整后比值比=1.4，p=0.20）增加了6个月持续戒烟的几率。直接比较两个干预组时未发现显著差异。
对于无法或不愿戒烟的吸烟者，应将减少吸烟量视为一种替代干预目标。
