Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy.
Int J Environ Res Public Health. 2018 Jun 11;15(6):1234. doi: 10.3390/ijerph15061234.
In Italy, the National Health Service offers specialized evidence-based support to smokers who would like to quit through smoking cessation (SC) services. We conducted a two-year prospective study, involving all 288 subjects treated for smoking cessation at the SC service of Reggio Emilia, to assess the association of referral sources and waiting times with the risk of treatment failure, by following participants up to one year after the quit date. We performed Cox-regression analysis, including demographic and smoking-related characteristics as confounding variables. The treatment failure rate at 12 months was 59.4% (171/288), including only 12 subjects lost to follow-up. The main mode of entry was self-referral (42.4%), followed by 32.6% from general practice, 17.4% from hospital and 7.6% from other sources. Only 27.8% participants were involved in the SC-program within 60 days of the first contact, as the guidelines suggest. The risk of treatment failure at 12 months showed little association with the type of referral source, while it correlated with waiting times ≥ 60 days (hazard ratio = 1.59; 95% confidence interval 1.10⁻2.29). This study provides evidence of long-term high quit rates from a SC service, with few subjects lost to follow-up and biochemical verification of almost all abstinent subjects. Timeliness in care provision could further improve the outcome.
在意大利，国家卫生服务局通过戒烟服务为有意愿戒烟的吸烟者提供专业的基于证据的支持。我们进行了一项为期两年的前瞻性研究，涉及雷焦艾米利亚戒烟服务中心治疗的所有 288 名戒烟者，通过随访参与者至戒烟日期后一年，评估转诊来源和等待时间与治疗失败风险之间的关联。我们进行了 Cox 回归分析，将人口统计学和与吸烟相关的特征作为混杂变量。12 个月时的治疗失败率为 59.4%（171/288），仅 12 名参与者失访。主要进入模式是自我转诊（42.4%），其次是全科医生转诊（32.6%）、医院转诊（17.4%）和其他来源转诊（7.6%）。只有 27.8%的参与者在首次接触后 60 天内参与了 SC 项目，这符合指南建议。12 个月时的治疗失败风险与转诊来源类型几乎没有关联，而与等待时间≥60 天相关（风险比=1.59；95%置信区间 1.10⁻2.29）。这项研究提供了戒烟服务长期高戒烟率的证据，失访人数较少，几乎所有戒烟者都进行了生化验证。及时提供护理可以进一步改善结果。
