Peer Nasheeta, Naicker Ashika, Khan Munira, Kengne Andre-Pascal
Non-Communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa.
Department of Medicine, University of Cape Town, Cape Town, South Africa.
SAGE Open Med. 2020 Jul 1;8:2050312120936907. doi: 10.1177/2050312120936907. eCollection 2020.
In the face of increasing tobacco consumption in Sub-Saharan Africa, it is crucial to not only curb the uptake of tobacco, but to ensure that tobacco users quit. Considering the minimal attention that tobacco cessation interventions receive in Sub-Saharan Africa, this review aims to describe studies that evaluated tobacco cessation interventions in the region.
A search of studies published till December 2019 that evaluated tobacco cessation interventions in Sub-Saharan Africa and examined tobacco quit rates was conducted in PubMed-Medline, Web of Science and Scopus. Study designs were not limited to randomised control trials but needed to include a control group.
Of the 454 titles and abstracts reviewed, eight studies, all conducted in South Africa, were included. The earliest publication was from 1988 and the most recent from 2019. Five studies were randomised control trials, two were quasi-experimental and one was a case-control study. Populations studied included community-based smokers (four studies) and university students, while the relevant clinic-based studies were conducted in pregnant women, tuberculosis patients and HIV-infected patients. Sample sizes were 23 in the case-control study, 87-561 in randomised control trials, and 979 (pregnant women) and 4090 (three rural communities) in the quasi-experimental studies. Four studies included nicotine replacement therapy in the interventions while four utilised only psychotherapy without adjunct pharmacotherapy. Quit rates were evaluated by exhaled carbon monoxide levels (five studies), blood carbon monoxide, urinary cotinine levels and self-reported quit rates. Four studies (two each with and without pharmacotherapy) reported significantly better outcomes in the intervention versus the control groups while one study findings (without pharmacotherapy) were significant in women but not men.
This review highlights that scant attention has been paid to tobacco cessation intervention in Sub-Saharan Africa. The heterogeneity of these studies precluded comparisons across interventions or populations. There is a need for evidence-based low-cost tobacco cessation intervention that target high-risk population in Sub-Saharan Africa.
面对撒哈拉以南非洲地区烟草消费不断增加的情况，不仅要遏制烟草的使用，还要确保烟草使用者戒烟，这至关重要。鉴于撒哈拉以南非洲地区的戒烟干预措施很少受到关注，本综述旨在描述评估该地区戒烟干预措施的研究。
在PubMed-Medline、科学网和Scopus数据库中检索截至2019年12月发表的评估撒哈拉以南非洲地区戒烟干预措施并研究烟草戒烟率的研究。研究设计不限于随机对照试验，但需要包括一个对照组。
在审查的454篇标题和摘要中，纳入了8项均在南非进行的研究。最早的出版物是1988年的，最新的是2019年的。5项研究为随机对照试验，2项为准实验研究，1项为病例对照研究。研究人群包括社区吸烟者（4项研究）和大学生，而相关的基于诊所的研究是在孕妇、结核病患者和艾滋病毒感染患者中进行的。病例对照研究的样本量为23，随机对照试验的样本量为87-561，准实验研究的样本量为979（孕妇）和4090（三个农村社区）。4项研究在干预措施中包括尼古丁替代疗法，4项仅采用心理治疗而无辅助药物治疗。通过呼出一氧化碳水平（5项研究）、血液一氧化碳、尿可替宁水平和自我报告的戒烟率来评估戒烟率。4项研究（两项有药物治疗，两项无药物治疗）报告干预组的结果明显优于对照组，而一项研究（无药物治疗）的结果在女性中显著，但在男性中不显著。
本综述强调，撒哈拉以南非洲地区对戒烟干预措施的关注很少。这些研究的异质性妨碍了对不同干预措施或人群进行比较。需要针对撒哈拉以南非洲地区高危人群开展基于证据的低成本戒烟干预措施。
