Department of Health and Human Performance, College of Charleston, Charleston, SC, USA.
Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
Nicotine Tob Res. 2021 Oct 7;23(11):1880-1888. doi: 10.1093/ntr/ntab095.
Smokers increasingly use e-cigarettes to try to quit smoking, even more than recommended cessation methods. However, few smokers discuss the range of cessation options with their physicians. Decision aids can inform smokers about smoking cessation options, including evidence about e-cigarettes, and encourage smokers to engage in shared decision making with their physician.
This study aimed to evaluate a smoking cessation decision aid that included e-cigarette risks and benefits. Adult smokers were recruited from primary care clinics for two research phases: (1) usability and acceptability testing of the decision aid (n = 37); and (2) pre-post study that compared usual care (n = 90) with implementation of the decision aid in clinics (n = 90). For the latter, outcome measures included frequency of clinical discussions of readiness to quit, methods to quit in general, and of specific cessation methods, in addition to decisional conflict, communication satisfaction, and overall patient satisfaction.
Smokers indicated high usability and acceptability of the decision aid. In the pre-post evaluation, decision aid implementation was associated with higher rates of smokers: being asked if they were ready to quit smoking (89% vs. 67%, respectively; p < .001); discussing methods for smoking cessation in general (81% vs. 48%; p < .001); and discussing specific cessation methods (NRT 55% vs. 26%, p < .001; prescription medications 26% vs. 12%, p = .022). Decision aid use was also associated with higher overall patient satisfaction with the physician visit.
Smoking cessation decision aids that incorporate information about e-cigarettes are acceptable among smokers and can lead to evidence-based clinical discussions about smoking cessation.
Smokers use e-cigarettes more than recommended cessation methods when they are trying to quit smoking, yet few physicians discuss the risks and benefits of e-cigarettes with their patients who smoke. This study presents preliminary findings about the feasibility and usability of a clinically based iPad-delivered smoking cessation decision aid that integrates information about e-cigarettes. Although promising, further research with randomized designs, larger samples, and longer-term follow-up is needed to determine whether this type of intervention can effectively promote cessation of all tobacco products and, for those not ready to quit smoking, the use of e-cigarettes for harm reduction.
越来越多的吸烟者使用电子烟来尝试戒烟，甚至超过了推荐的戒烟方法。然而，很少有吸烟者与他们的医生讨论戒烟的各种选择。决策辅助工具可以向吸烟者提供有关戒烟选择的信息，包括电子烟的证据，并鼓励吸烟者与他们的医生共同做出决策。
本研究旨在评估一种包含电子烟风险和益处的戒烟决策辅助工具。从初级保健诊所招募成年吸烟者参加两个研究阶段：（1）决策辅助工具的可用性和可接受性测试（n=37）；（2）比较常规护理（n=90）与诊所实施决策辅助工具（n=90）的预-后研究。对于后者，结果测量包括临床讨论戒烟准备情况、一般戒烟方法和特定戒烟方法的频率，以及决策冲突、沟通满意度和整体患者满意度。
吸烟者表示对决策辅助工具的可用性和可接受性很高。在预-后评估中，决策辅助工具的实施与更高的吸烟者比例相关：被问到是否准备戒烟（分别为 89%和 67%；p<0.001）；讨论一般戒烟方法（分别为 81%和 48%；p<0.001）；以及讨论特定戒烟方法（NRT 为 55%和 26%，p<0.001；处方药物为 26%和 12%，p=0.022）。使用决策辅助工具也与患者对医生就诊的整体满意度更高相关。
包含电子烟信息的戒烟决策辅助工具在吸烟者中是可接受的，可以促进基于证据的戒烟临床讨论。
吸烟者在试图戒烟时使用电子烟的频率超过了推荐的戒烟方法，然而，很少有医生与他们的烟民患者讨论电子烟的风险和益处。本研究提出了一项基于临床的 iPad 戒烟决策辅助工具的可行性和可用性的初步研究结果，该工具整合了有关电子烟的信息。虽然有希望，但需要进行更多具有随机设计、更大样本量和更长随访时间的研究，以确定这种干预措施是否能有效促进所有烟草产品的戒烟，对于那些还没有准备好戒烟的人，是否能促进电子烟的使用以减少危害。
