Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, Canada.
Nicotine Tob Res. 2021 May 24;23(6):976-982. doi: 10.1093/ntr/ntaa214.
Smoking behaviour shows seasonal variation, with cigarette consumption and youth smoking onset highest in summer and smoking-related web searches and sales of nicotine replacement products highest in winter. Variation in demand for clinical care and in outcomes has not been explored.
We measure seasonal variation in enrolments, total clinical visits, visits per enrolment, and treatment outcome (7-day abstinence at 6-month follow-up) from 2015 to 2018 in a large (n = 85 869) clinical cohort from 454 clinics across Ontario, Canada. We model seasonality using harmonic logistic and negative binomial regression. For individual-level outcomes, we adjust for variables, selected a priori, known to be associated with treatment use or outcomes. Data are nearly complete for 3 outcomes, but 6m abstinence is missing for 45% of participants. We use multiple imputation to adjust for missing data.
All four outcomes showed significant seasonal variation (all p <.001). Total enrolments and visits were 20%-25% higher in January-April than in June-September. Visits per enrolment varied slightly, with lowest levels from May-July. Abstinence at 6 months was lowest among individuals enrolled from February-May and highest for those enrolled from July-November, with an absolute peak-trough difference of 4.3% (95% CI = 3.2% to 5.5%).
There is meaningful seasonal variation in demand for, and outcomes of, smoking cessation treatment. Climate and weather may be indirectly responsible. Seasonal differences underscore the general importance of contextual factors in smoking cessation, may be useful in program promotion, and may explain some variability in outcomes in evaluation and research.
Demand for tobacco cessation treatment and clinical outcomes vary seasonally. This underscores the importance of context in substance-related problems, and implies that some variability in research and evaluation results may be due to the time of year data were collected. Promotion efforts might usefully consider seasonal effects to smooth out demand and possibly improve outcomes.
吸烟行为具有季节性变化，夏季的香烟消费量和青少年吸烟率最高，冬季与吸烟相关的网络搜索和尼古丁替代产品的销售量最高。尚未探讨对临床护理的需求和结果的变化。
我们从加拿大安大略省 454 家诊所的一个大型（n=85869）临床队列中，测量了 2015 年至 2018 年期间的入组人数、总临床就诊次数、每次入组的就诊次数和治疗结果（6 个月随访时的 7 天戒烟率）的季节性变化。我们使用调和逻辑回归和负二项回归来模拟季节性变化。对于个体水平的结果，我们根据预先选择的已知与治疗使用或结果相关的变量进行调整。3 个结果的数据几乎完整，但 6m 戒烟率缺失了 45%的参与者。我们使用多重插补来调整缺失数据。
所有四个结果均显示出显著的季节性变化（均 p<0.001）。1 月至 4 月的总入组人数和就诊次数比 6 月至 9 月高 20%-25%。每次入组的就诊次数略有不同，5 月至 7 月最低。6 个月时的戒烟率在 2 月至 5 月入组的个体中最低，在 7 月至 11 月入组的个体中最高，绝对峰谷差异为 4.3%（95%CI=3.2%至 5.5%）。
戒烟治疗的需求和结果存在有意义的季节性变化。气候和天气可能是间接原因。季节性差异突出了吸烟戒断中环境因素的普遍重要性，可能对项目推广有用，并可能解释评估和研究结果中的一些变异性。
对烟草戒断治疗的需求和临床结果随季节变化而变化。这突出了物质相关问题背景的重要性，并且意味着研究和评估结果中的一些变异性可能是由于收集数据的时间所致。推广工作可能会考虑季节性影响，以平稳需求并可能改善结果。
