UK Centre for Tobacco and Alcohol Studies, School of Medicine, University of Nottingham, Nottingham, UK.
UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
Addiction. 2018 Aug;113(8):1499-1506. doi: 10.1111/add.14204. Epub 2018 Apr 16.
To assess tobacco dependence treatment guidelines content in accordance with Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and its guidelines, and association between content and country income level.
Cross-sectional study.
On-line survey from March to July 2016.
Contacts in 77 countries, including 68 FCTC Parties, six Signatories and three non-Parties which had indicated having guidelines in previous surveys, or had not been surveyed before.
A nine-item questionnaire on guidelines content, key recommendations, writing and dissemination.
We received responses from contacts in 63 countries (82%); 61 had guidelines. The majority are for doctors (93%), primary care (92%) and nurses (75%). All recommend brief advice, 82% recording tobacco use in medical notes, 98% nicotine replacement therapy (NRT), 61% quitlines, 31% text messaging and 87% intensive specialist support, and 54% stress the importance of health-care workers not using tobacco. Only 57% have a dissemination strategy, and 62% have not been updated for 5 or more years. Compared with high-income countries, quitlines are less likely to be recommended in upper middle-income countries guidelines [odds ratio (OR) = 0.15, 95% confidence interval (CI) = 0.04-0.61] and intensive specialist support in lower middle-income countries guidelines (OR = 0.01, 95% CI = 0.00-0.20). Guidelines updating is associated positively with country income level (P = 0.027).
Although most tobacco dependence treatment guidelines in the 61 countries assessed in 2016 follow the World Health Organization's Framework Convention on Tobacco Control Article 14 recommendations and do not differ significantly by income level, improvements are needed in keeping guidelines up-to-date, applying good writing practices and developing a dissemination strategy.
根据世界卫生组织（WHO）《烟草控制框架公约》（FCTC）第 14 条及其指南评估烟草依赖治疗指南的内容，并评估内容与国家收入水平之间的关联。
横断面研究。
2016 年 3 月至 7 月的在线调查。
来自 77 个国家的联系人，包括 68 个 FCTC 缔约方、6 个签署国和 3 个非缔约方，这些国家之前的调查表明有指南，或以前未进行过调查。
关于指南内容、主要建议、编写和传播的九项问卷。
我们收到了来自 63 个国家（82%）联系人的回复；其中 61 个国家有指南。大多数是针对医生（93%）、初级保健（92%）和护士（75%）。所有指南都建议简短的建议，82%的指南记录医疗记录中的烟草使用情况，98%的指南推荐尼古丁替代疗法（NRT），61%的戒烟热线，31%的短信服务和 87%的强化专科支持，54%的指南强调医护人员不使用烟草的重要性。只有 57%的指南有传播策略，62%的指南已经 5 年或更长时间没有更新。与高收入国家相比，中高收入国家的指南中较少推荐戒烟热线[比值比（OR）=0.15，95%置信区间（CI）=0.04-0.61]，而中低收入国家的指南中较少推荐强化专科支持（OR=0.01，95%CI=0.00-0.20）。指南更新与国家收入水平呈正相关（P=0.027）。
尽管 2016 年评估的 61 个国家的大多数烟草依赖治疗指南都遵循世界卫生组织《烟草控制框架公约》第 14 条的建议，并且与收入水平没有显著差异，但在保持指南的最新、应用良好的写作实践和制定传播策略方面仍需要改进。
