Department of Public Health, Hokkaido University Faculty of Medicine.
Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.
J Atheroscler Thromb. 2018 Apr 1;25(4):323-334. doi: 10.5551/jat.42051. Epub 2017 Dec 2.
We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers.
The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index.
In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was ＋2.64% (95% confidence interval: ＋1.51% to ＋3.77%) for males and ＋3.11% (－1.85% to ＋8.07%) for females. The ATE of single counseling was ＋0.61% (－1.17% to ＋2.38%) for males and －1.06% (－5.96% to ＋3.85%) for females.
In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.
本研究旨在探讨日本全国心血管病预防系统中的两种个性化健康指导（重复和单次咨询）是否能促进吸烟者戒烟。
该研究纳入了 47745 名年龄在 40 至 74 岁之间的日本吸烟者，他们被分为两种个性化健康指导方案。经过 1 年的随访，我们比较了接受咨询（“支持组”）和未接受咨询（“非支持组”）者的戒烟率。采用倾向评分匹配分析，在平衡支持组和非支持组之间的特征后，估计每种方法对戒烟的平均处理效应（ATE）。倾向评分回归模型包括年龄、医疗保险类型、20 岁后体重增加、运动、饮食习惯、饮酒量、睡眠质量、改变生活方式的准备情况、接受支持的意愿和体重指数。
在重复咨询方案中，支持组和非支持组男性的戒烟率分别为 8.8%和 6.3%，女性的相应戒烟率分别为 9.8%和 9.1%。在单次咨询方案中，支持组和非支持组男性的戒烟率分别为 8.4%和 7.3%，女性的相应戒烟率分别为 11.0%和 11.7%。重复咨询的 ATE 为男性＋2.64%（95%置信区间：1.51%至 3.77%），女性＋3.11%（1.85%至 8.07%）。单次咨询的 ATE 为男性＋0.61%（-1.17%至 2.38%），女性-1.06%（-5.96%至 3.85%）。
在日本心血管病预防系统中，重复咨询可能会促进男性吸烟者戒烟。
