Department of Psychiatry and Psychotherapy, Medical Center of the University of Munich, Nussbaumstrasse 7, 80336, Munich, Germany.
IFT Gesundheitsförderung Gesellschaft mbH, Montsalvatstrasse 14, 80804, Munich, Germany.
Eur Arch Psychiatry Clin Neurosci. 2018 Apr;268(3):269-277. doi: 10.1007/s00406-017-0818-6. Epub 2017 Jun 14.
The vast majority of smokers are unable or unwilling to quit, but many are open to reducing smoking. No treatment options exist for these smokers besides medication-based therapies. Thus, this study investigated the efficacy of a cognitive behavioral therapy (CBT) smoking reduction program, Smoke_less. A sample of 155 outpatient smokers aged 18-70 years was recruited at the Tobacco Dependence Outpatient Clinic of the Medical Center of the University of Munich, Germany, and randomly assigned to the experimental group (Smoke_less: four weekly CBT group sessions and two telephone calls over 5 weeks, n = 51), active comparator group (one 15-minute counseling session, n = 49), or waiting control group (no intervention during the study, n = 55). The primary endpoint was a ≥50% smoking reduction in the intention-to-treat group 1 week and 6 months after the intervention. We evaluated also abstinence rates at follow-up. Significantly more participants in the Smoke_less group had reduced smoking ≥50% compared to the waiting group at 1 week [OR 7.59 (2.59-22.19)] and 6 months [OR 5.00 (1.68-14.84)] and compared to the active comparison group at 1 week [OR 8.58 (2.67-27.31)] but not at 6 months [OR 1.73 (0.71-4.20)]. We found no significant effects on abstinence rates. The CBT smoking reduction program Smoke_less is effective for smoking reduction but is superior to brief counseling only in the short term. Further research is required to improve its efficacy in long-term smoking reduction to provide a valid, non-medication-based alternative to smokers unable or unwilling to quit.
Clinicaltrials.gov Identifier: NCT02337400.
本研究旨在评估认知行为疗法（CBT）戒烟减少项目 Smoke_less 的疗效。
在德国慕尼黑大学医学中心的烟草依赖门诊，招募了 155 名年龄在 18-70 岁的门诊吸烟者，他们被随机分配到实验组（Smoke_less：4 次每周的 CBT 小组会议和 5 周内 2 次电话随访，n=51）、活性对照组（1 次 15 分钟的咨询，n=49）或等待对照组（研究期间无干预，n=55）。主要终点是治疗组在干预后 1 周和 6 个月时的吸烟量减少≥50%。我们还评估了随访时的戒烟率。
与等待组相比，Smoke_less 组在 1 周和 6 个月时的吸烟量减少≥50%的参与者显著更多[1 周时 OR 7.59（2.59-22.19），6 个月时 OR 5.00（1.68-14.84）]，与活性对照组相比，Smoke_less 组在 1 周时的吸烟量减少≥50%的参与者也显著更多[OR 8.58（2.67-27.31）]，但在 6 个月时则没有[OR 1.73（0.71-4.20）]。我们没有发现戒烟率有显著影响。
CBT 戒烟减少项目 Smoke_less 对减少吸烟量有效，但仅在短期内优于简短咨询。需要进一步研究来提高其在长期减少吸烟量方面的疗效，为无法或不愿戒烟的吸烟者提供一种有效的、非药物治疗的替代方法。
