Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Kaiser Permanente Washington Health Research Institute, Seattle, WA.
Nicotine Tob Res. 2020 Oct 8;22(10):1860-1866. doi: 10.1093/ntr/ntaa099.
Affective disorders and symptoms (ADS) are predictive of lower odds of quitting smoking. However, it is unknown which approach to assessing ADS best predicts cessation. This study compared a battery of ADS screening instruments with a single, self-report question on predicting cessation. Among those who self-reported ADS, we also examined if an additional question regarding whether participants believed the condition(s) might interfere with their ability to quit added predictive utility to the single-item question.
Participants (N = 2637) enrolled in a randomized controlled trial of web-based smoking treatments completed a battery of five ADS screening instruments and answered a single-item question about having ADS. Those with a positive self-report on the single-item question were also asked about their interference beliefs. The primary outcome was complete-case, self-reported 30-day point prevalence abstinence at 12 months.
Both assessment approaches significantly predicted cessation. Screening positive for ≥ one ADS in the battery was associated with 23% lower odds of quitting than not screening positive for any (p = .023); those with a positive self-report on the single-item had 39% lower odds of quitting than self-reporting no mental health conditions (p < .001). Area under the receiver operating characteristic curve values for the two assessment approaches were similar (p = .136). Adding the interference belief question to the single-item assessment significantly increased the area under the receiver operating characteristic curve value (p = .042).
The single-item question assessing ADS had as much predictive validity, and possibly more, than the battery of screening instruments for identifying participants at risk for failing to quit smoking. Adding a question about interference beliefs significantly increased the predictive utility of the single-item question.
This is the first study to demonstrate that a single-item question assessing ADS has at least as much predictive validity, and possibly more, than a battery of validated screening instruments for identifying smokers at highest risk for cessation failure. This study also demonstrates adding a question about interference beliefs significantly adds to the predictive utility of a single, self-report question about mental health conditions. Findings from this study can be used to inform decisions regarding how to assess ADS in the context of tobacco treatment settings.
情感障碍和症状（ADS）可预测戒烟的可能性降低。然而，尚不清楚评估 ADS 的哪种方法最能预测戒烟成功。本研究比较了一系列 ADS 筛查工具与单一的、关于预测戒烟成功的自我报告问题，来预测戒烟成功。在那些自我报告 ADS 的人中，我们还研究了是否增加一个关于参与者是否认为这些情况可能会干扰他们戒烟能力的问题，是否会为单项问题增加预测价值。
参加基于网络的吸烟治疗随机对照试验的 2637 名参与者完成了五组 ADS 筛查工具和一个关于是否患有 ADS 的单项问题。那些在单项问题上自我报告阳性的人还被问及他们的干扰信念。主要结局是在 12 个月时完全自我报告的 30 天点患病率戒烟率。
两种评估方法均显著预测了戒烟成功。与不筛查任何 ADS 的人相比，在筛查工具中至少有一项筛查阳性的人戒烟的可能性降低 23%（p =.023）；那些在单项问题上自我报告阳性的人戒烟的可能性比自我报告没有心理健康问题的人低 39%（p <.001）。两种评估方法的受试者工作特征曲线下面积值相似（p =.136）。将干扰信念问题添加到单项评估中显著增加了受试者工作特征曲线下面积值（p =.042）。
评估 ADS 的单项问题与用于识别有戒烟失败风险的参与者的一系列经过验证的筛查工具相比，具有相同或更高的预测准确性。增加一个关于干扰信念的问题显著提高了单项问题的预测价值。
这是第一项表明评估 ADS 的单项问题至少与用于识别最有可能戒烟失败的吸烟者的经过验证的筛查工具一样具有预测准确性，并且可能更高的研究。本研究还表明，增加一个关于干扰信念的问题显著增加了关于心理健康状况的单一自我报告问题的预测价值。本研究的结果可以用于告知在烟草治疗环境中评估 ADS 的决策。
