免费尼古丁替代疗法能否提高癌症患者的戒烟率？

Does free nicotine replacement improve smoking cessation rates in cancer patients?

机构信息

Division of Radiation Oncology, London Regional Cancer Program, London.

Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON.

出版信息

Curr Oncol. 2020 Feb;27(1):14-18. doi: 10.3747/co.27.5267. Epub 2020 Feb 1.

DOI:10.3747/co.27.5267

PMID:32218655

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7096202/

Abstract

BACKGROUND

Cigarette smoking is carcinogenic and has been linked to inferior treatment outcomes and complication rates in cancer patients. Here, we report the results of an 18-month pilot smoking cessation program that provided free nicotine replacement therapy (nrt).

METHODS

In January 2017, the smoking cessation program at our institution began offering free nrt for actively cigarette-smoking patients with cancer. The cost of 4 weeks of nrt was covered by the program, and follow-up was provided by smoking cessation champions.

RESULTS

From January 2017 to June 2018, 8095 patients with cancer were screened for cigarette use, of whom 1135 self-identified as current or recent smokers. Of those 1135 patients, 117 enrolled in the program and accepted a prescription for nrt. The rates of patient referral and patients attending a referral appointment were significantly higher in 2018-2018 than they had been in 2015-2016 (100% vs. 80.3%, < 0.001, and 27.6% vs. 11.3%, < 0.001, respectively). Median follow-up was 9.0 months (25%-75% interquartile range: 5.7-11.6 months). Of the patients who accepted nrt and who also had complete data ( = 71), 25 (35.2%) reported complete smoking cessation, and 32 (45.1%) reported only decreased cigarette smoking. On univariable analysis, no factors were significantly predictive of smoking cessation, although initial cigarette use (>10 vs. ≤10 initial cigarettes) was significantly predictive of smoking reduction (odds ratio: 5.04; 95% confidence interval: 1.46 to 17.45; = 0.011).

CONCLUSIONS

This pilot study of free nrt demonstrated rates of referral and acceptance of nrt that were improved compared with historical rates, and most referred patients either decreased their use of cigarettes or quit entirely.

摘要

背景

吸烟致癌，并与癌症患者治疗效果不佳和并发症发生率升高有关。在此，我们报告了一项为期 18 个月的试点戒烟计划的结果，该计划提供免费尼古丁替代疗法（NRT）。

方法

2017 年 1 月，我院的戒烟计划开始为积极吸烟的癌症患者提供免费的 NRT。该计划承担了四周 NRT 的费用，并由戒烟冠军提供随访。

结果

从 2017 年 1 月到 2018 年 6 月，对 8095 名癌症患者进行了吸烟筛查，其中 1135 名自我认定为当前或近期吸烟者。在这 1135 名患者中，有 117 名参加了该计划，并接受了 NRT 的处方。与 2015-2016 年相比，2018-2018 年患者转诊率和参加转诊预约的患者比例显著提高（100% vs. 80.3%，<0.001；27.6% vs. 11.3%，<0.001）。中位随访时间为 9.0 个月（25%-75%四分位间距：5.7-11.6 个月）。在接受 NRT 且数据完整的患者中（n=71），25 名（35.2%）报告完全戒烟，32 名（45.1%）报告仅减少吸烟。单变量分析显示，没有因素对戒烟有显著预测作用，尽管初始吸烟量（>10 支 vs. ≤10 支）对吸烟减少有显著预测作用（比值比：5.04；95%置信区间：1.46 至 17.45；=0.011）。