Department of Public Health Sciences and Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.
Cancer Control Research Program, Hollings Cancer Center, Charleston, SC.
Nicotine Tob Res. 2021 May 24;23(6):1064-1067. doi: 10.1093/ntr/ntaa266.
The purpose of this study was to evaluate a pilot preoperative contingency management (CM) intervention for smoking abstinence.
This multisite pilot study was conducted at two cancer center-based tobacco treatment programs. Participants who were smoking, diagnosed with or suspected to have any type of operable cancer, and had a surgical procedure scheduled in the next 10 days to 5 weeks (N = 40) were randomized to receive standard care plus monitoring only (MO) or CM prior to surgery. All patients received breath carbon monoxide (CO) tests 3 times per week, nicotine patches, and counseling. The CM group also earned payments for self-reported smoking abstinence confirmed by CO breath test ≤6 ppm on an escalating schedule of reinforcement (with a reset if they smoked). Seven-day point prevalence abstinence rates on the day of surgery and at 3-month follow-up were compared between groups using repeated measures log-linear regression models utilizing generalized estimating equations. Participants lost to follow-up are assumed to have returned to smoking.
The sample was 50% female and 75% White. In covariate adjusted models, patients in the CM group had a greater probability of reported abstinence. On the day of surgery (end of treatment), 52% of CM patients were abstinent compared with 16% of patients in MO (risk ratio = 3.2 [1.1-9.3]; p = .03). At the 3-month follow-up, 43% of CM patients were abstinent compared with 5% in MO (risk ratio = 8.4 [1.5-48.3]; p = .02).
Providing monetary incentives contingent on abstinence prior to cancer surgery may produce significant improvements in smoking abstinence rates relative to breath CO MO.
In this pilot preoperative CM intervention for smoking abstinence, patients receiving a CM intervention prior to cancer surgery had a greater probability of smoking abstinence at the end of treatment compared with a breath MO group (52% vs. 16%, respectively). Thus, providing monetary incentives contingent on abstinence may produce significant improvements in smoking abstinence rates prior to cancer surgery relative to breath CO monitoring.
本研究旨在评估一项针对戒烟的术前应急管理（CM）干预的试点研究。
这项多中心的试点研究在两家癌症中心的烟草治疗项目中进行。参与者为吸烟者，诊断出或怀疑患有任何类型的可手术癌症，且在接下来的 10 天至 5 周内安排了手术（N=40），他们被随机分配到仅接受标准护理（MO）或手术前的 CM 治疗。所有患者每周接受 3 次呼吸一氧化碳（CO）测试，尼古丁贴片和咨询。CM 组还根据递增强化时间表（如果吸烟，则重置），因自我报告的戒烟并通过 CO 呼气测试≤6 ppm 而获得报酬。使用广义估计方程的重复测量对数线性回归模型比较了两组在手术当天和 3 个月随访时的 7 天点患病率戒烟率。随访丢失的患者被假定为恢复吸烟。
样本中 50%为女性，75%为白人。在协变量调整模型中，CM 组患者的戒烟可能性更大。在手术当天（治疗结束时），CM 组中有 52%的患者戒烟，而 MO 组中只有 16%的患者（风险比=3.2[1.1-9.3]；p=0.03）。在 3 个月随访时，CM 组中有 43%的患者戒烟，而 MO 组中只有 5%的患者（风险比=8.4[1.5-48.3]；p=0.02）。
在癌症手术前提供基于戒烟的金钱激励可能会显著提高戒烟率，与呼吸 CO MO 相比。
在这项针对戒烟的术前 CM 干预的试点研究中，与呼吸 MO 组（52%对 16%）相比，接受癌症手术前 CM 干预的患者在治疗结束时更有可能戒烟。因此，与呼吸 CO 监测相比，提供基于戒烟的金钱激励可能会显著提高癌症手术前的戒烟率。
