吸烟者诊所中复吸吸烟者与初次吸烟者治疗成功率的比较。

Comparison between success rates for smokers re-treated by a smokers' clinic and success rates for smokers treated for the first time.

机构信息

Centre for Tobacco Dependence, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.

Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic.

出版信息

Addiction. 2021 Feb;116(2):346-355. doi: 10.1111/add.15175. Epub 2020 Jul 18.

DOI:10.1111/add.15175

PMID:32592219

Abstract

AIMS

To compare success rates and characteristics of smokers treated a second time by a smokers' clinic with success rates of their first treatment.

DESIGN

Retrospective cohort study.

SETTING

Tobacco Dependence Treatment clinic in Prague, Czech Republic, between 2005 and 2017.

PARTICIPANTS

A total of 5225 smokers treated either once (n = 5006, single treatment sample, SS) or also second time (n = 219, re-treated sample, RS), on average 4.47 years after the first visit.

INTERVENTION

Smokers received intensive treatment of tobacco dependence with pharmacotherapy options. Outcomes were evaluated after 1 year. In case of failure or relapse, participants could undergo re-treatment in the same setting at least 1 year after the start of the first treatment.

MEASUREMENTS

Twelve-month self-reported continuous abstinence; CO-validated (≤ 6 parts per million); number of visits; type of pharmacotherapy; mental health history; Fagerström Test for Cigarette Dependence; time between first and second treatment.

RESULTS

The abstinence rate in the SS was 34.8% [95% confidence interval (CI) = 33.4%, 36.1%] and in the RS was 37% (95% CI = 30.6%, 43.8%) and 39.7% (95% CI = 33.2%, 45.5%) for their first and second treatments, respectively. The samples were comparable on smoking and socio-demographic characteristics and pharmacotherapy used, but the RS in the second treatment had a higher prevalence of diagnosed mental health disorder at 39.3% (95% CI = 32.8%; 46.1%) compared with 23.7% (95% CI = 22.5%; 24.9%) in the SS. Participants who initiated their second quit attempt 1 to 2 years after the first one were less successful than those who initiated their second quit attempt later (25 versus 43%; P < 0.05). The results of the first treatment cycle were not found to be a reliable predictor for outcomes of the second cycle of treatment in univariate or multivariate logistic regression (odds ratio = 1.35, 95% CI = 0.70-2.63, P = 0.373).

CONCLUSION

In Prague, Czech Republic, smokers re-attending stop-smoking treatment more than 2 years after their previous quit attempt appear to achieve similar success rates to those being treated for the first time.

摘要

目的

比较吸烟者诊所第二次治疗的成功率和特点与首次治疗的成功率。

设计

回顾性队列研究。

地点

捷克布拉格的烟草依赖治疗诊所，2005 年至 2017 年。

参与者

共 5225 名吸烟者，其中一次治疗（n=5006，单次治疗样本，SS）或两次治疗（n=219，再治疗样本，RS），平均在第一次就诊后 4.47 年。

干预措施

吸烟者接受了药物治疗选择的烟草依赖强化治疗。在 1 年后评估结果。如果失败或复发，参与者可以在首次治疗开始至少 1 年后在同一环境中进行再治疗。

测量

12 个月的自我报告连续戒烟；CO 验证（≤6 ppm）；就诊次数；药物治疗类型；心理健康史；Fagerström 吸烟依赖性测试；第一次和第二次治疗之间的时间。

结果

SS 的戒烟率为 34.8%[95%置信区间（CI）=33.4%，36.1%]，RS 的戒烟率分别为 37%（95% CI=30.6%，43.8%）和 39.7%（95% CI=33.2%，45.5%）。两次治疗的样本在吸烟和社会人口统计学特征以及使用的药物治疗方面具有可比性，但 RS 在第二次治疗中的精神健康障碍诊断率为 39.3%（95% CI=32.8%，46.1%），而 SS 为 23.7%（95% CI=22.5%，24.9%）。与首次戒烟尝试后 1 至 2 年内开始第二次戒烟尝试的参与者相比，首次戒烟尝试后超过 2 年开始第二次戒烟尝试的参与者成功率较低（25%比 43%；P<0.05）。在单变量或多变量逻辑回归中，第一次治疗周期的结果未被发现是第二次治疗周期结果的可靠预测因素（优势比=1.35，95% CI=0.70-2.63，P=0.373）。