Education Division, SRI International, Menlo Park, CA, USA.
Optum Center for Wellbeing Research, Optum, Seattle, WA USA.
Ann Behav Med. 2019 Nov 9;53(12):1032-1044. doi: 10.1093/abm/kaz014.
Understanding the characteristics of smokers who are successful in quitting may help to increase smoking cessation rates.
To examine heterogeneity in cessation outcome at 6 months following smoking cessation behavioral counseling with or without weight management counseling.
2,540 smokers were recruited from a large quitline provider and then randomized to receive proactive smoking cessation behavioral counseling without or with two versions of weight management counseling. A Classification and Regression Tree (CART) analysis was conducted to identify the individual pretreatment and treatment characteristics of groups of smokers with different quitting success (as measured by point prevalence of self-reported smoking of any amount at 6 months).
CART analysis identified 10 subgroups ranging from 25.5% to 70.2% abstinent. The splits in the CART tree involved: the total number of counseling and control calls received, whether a smoking cessation pharmacotherapy was used, and baseline measures of cigarettes per day, confidence in quitting, expectation that the study would help the participant quit smoking, the motivation to quit, exercise minutes per week, anxiety, and lack of interest or pleasure in doing things. Costs per quitter ranged from a low of $US270 to a high of $US630. Specific treatment recommendations are made for each group.
These results indicate the presence of a substantial variation in abstinence following treatment, and that the total extent of contact via counseling calls of any type and baseline characteristics, rather than assigned treatment, were most important to subgroup membership and abstinence. Tailored treatments to subgroups who are at high risk for smoking following a quit attempt could increase successful smoking cessation.
了解成功戒烟者的特征可能有助于提高戒烟率。
研究在进行戒烟行为咨询（有无体重管理咨询）后 6 个月，戒烟结果的异质性。
从一家大型戒烟热线服务机构招募了 2540 名吸烟者，然后将他们随机分为接受主动戒烟行为咨询（有无体重管理咨询）两组。采用分类回归树（CART）分析来识别不同戒烟成功（以 6 个月时自我报告的任何量吸烟的点患病率衡量）的吸烟者群体的个体治疗前和治疗特征。
CART 分析确定了 10 个亚组，范围从 25.5%到 70.2%的戒烟率。CART 树的分支涉及：接受的咨询和对照电话的总数、是否使用戒烟药物治疗、每天吸烟的基数、戒烟信心、预期研究将帮助参与者戒烟、戒烟动机、每周锻炼分钟数、焦虑以及对做事缺乏兴趣或乐趣。每位戒烟者的费用从 270 美元到 630 美元不等。为每个组提出了具体的治疗建议。
这些结果表明，治疗后存在明显的戒烟成功率差异，且总接触程度（通过任何类型的咨询电话）和基线特征，而不是分配的治疗方案，对亚组归属和戒烟成功率最重要。为尝试戒烟后吸烟风险较高的亚组提供量身定制的治疗方案可能会增加成功戒烟的机会。
