Mental Health Services, San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Psychiatry, University of California, San Francisco, San Francisco, California.
Mental Health Services, San Francisco Veterans Affairs Health Care System, San Francisco, California; Department of Psychiatry, University of California, San Francisco, San Francisco, California.
Am J Prev Med. 2018 Jan;54(1):124-128. doi: 10.1016/j.amepre.2017.08.016. Epub 2017 Oct 23.
The purpose of this study is to examine the feasibility and acceptability of incorporating a mobile application, Stay Quit Coach, into an integrated care smoking-cessation treatment protocol for veterans with posttraumatic stress disorder (PTSD).
Participants included veteran smokers aged 18-69 years with PTSD. The integrated care protocol includes eight weekly PTSD-informed cognitive behavioral therapy sessions for smoking cessation, followed by monthly booster sessions and a prescription for standard smoking-cessation medications if desired. Participants used Stay Quit Coach as desired. Outcome measures at 3-month follow-up included: adherence (sessions attended), 30-day point-prevalence abstinence bioverified with carbon monoxide <6 parts per million, past-30 day mean daily cigarette use, exhaled carbon monoxide, nicotine dependence, and PTSD symptom severity. Repeated outcomes were analyzed with random-intercept linear mixed models. Data were collected in 2015-2016 and analyses were conducted in 2016-2017.
Participants (n=20) were 95% male and 5% female; mean age 41.4 (SD=16.2) years. Thirteen participants (65%) attended all scheduled sessions, four (20%) did not adhere to the protocol on schedule, and three (15%) were lost to follow-up. At 3-month follow-up, six of 17 completers (35.3%) had bioverified 30-day point-prevalence abstinence. Nicotine dependence, carbon monoxide levels, and past 30-day cigarette use significantly decreased and PTSD symptoms were unchanged from baseline to follow-up. Participants self-reported using Stay Quit Coach 2.5 (SD=2.2) days/week; 15 of 17 (88.2%) reported using Stay Quit Coach <30 minutes/week; two of 17 (11.8%) reported using Stay Quit Coach 30-60 minutes/week.
Although results must be interpreted with caution given the lack of control group and small sample size, findings indicate that integrating Stay Quit Coach into integrated care was feasible and acceptable.
本研究旨在探讨将移动应用 Stay Quit Coach 纳入针对创伤后应激障碍（PTSD）退伍军人的综合护理戒烟治疗方案的可行性和可接受性。
参与者包括年龄在 18-69 岁之间的患有 PTSD 的退伍军人吸烟者。综合护理方案包括八周每周一次的 PTSD 知情认知行为疗法戒烟疗程，随后每月进行强化疗程，并根据需要开具标准戒烟药物处方。参与者根据需要使用 Stay Quit Coach。3 个月随访时的结果包括：（参加的）课程依从性（出席的课程数）、经一氧化碳<6ppm 生物验证的 30 天点前戒烟率、过去 30 天平均每日吸烟量、呼出一氧化碳、尼古丁依赖和 PTSD 症状严重程度。采用随机截距线性混合模型分析重复结果。数据于 2015-2016 年收集，分析于 2016-2017 年进行。
参与者（n=20）中 95%为男性，5%为女性；平均年龄 41.4（SD=16.2）岁。13 名参与者（65%）按计划参加了所有预定课程，4 名（20%）未按计划遵守方案，3 名（15%）失访。在 3 个月随访时，17 名完成者中有 6 名（35.3%）经生物验证达到 30 天点前戒烟率。尼古丁依赖、一氧化碳水平和过去 30 天吸烟量从基线到随访显著下降，PTSD 症状保持不变。参与者自我报告每周使用 Stay Quit Coach 2.5（SD=2.2）天；17 名参与者中有 15 名（88.2%）报告每周使用 Stay Quit Coach<30 分钟；17 名参与者中有 2 名（11.8%）报告每周使用 Stay Quit Coach 30-60 分钟。
尽管由于缺乏对照组和样本量小，结果必须谨慎解释，但研究结果表明，将 Stay Quit Coach 纳入综合护理是可行且可接受的。
