Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy.
Emergency Department, "Maggiore della Carità" University Hospital, Novara, Italy.
Eur J Public Health. 2022 Feb 1;32(1):119-125. doi: 10.1093/eurpub/ckab114.
5A's counselling is recommended for screening and treating patients with smoking addiction. The emergency department (ED) setting might be a suitable environment for conducting interventions for smoking cessation. The present study aims to determine the feasibility and effectiveness on smoking cessation of 5A's counselling administered to ED patients by nurses.
Parallel group randomized trial assessing 5A's counselling for smoking cessation vs. usual care at a University Hospital in the North of Italy. The primary end-point was prevalence of tobacco-free patients. The secondary outcomes at 6- and 12-month follow-up were (i) consecutive past 30-day smoking abstinence; (ii) past 7-day 50%, or more, decrease in daily tobacco consumption over baseline; and (iii) number of attempts to quit smoking.
A total of 480 patients were randomized to intervention (n = 262) or usual care (n = 218). Intention to treat analysis displayed no differences in primary and secondary outcomes between groups. A slight but not statistically significant enhancement in cessation was recorded in the intervention group [relative risk (RR) = 1.04, 95% confidence interval (CI) = 0.58-1.87] at 6 months, whereas a reversed observation at 12 months (RR = 0.86, 95% CI = 0.50-1.47). Similar results were obtained for the secondary outcomes. Per protocol analysis increased the size of the results. Of the 126 smokers receiving counselling, 18 were visited and treated at the local smoking cessation centre, with 12 of them successfully completing the treatment.
The results of this study indicate that the ED is not a suited environment for 5A's counselling.
5A 咨询被推荐用于筛查和治疗吸烟成瘾患者。急诊科（ED）环境可能是实施戒烟干预的合适环境。本研究旨在确定由护士在 ED 患者中进行的 5A 咨询对戒烟的可行性和效果。
一项在意大利北部一所大学医院进行的 5A 咨询戒烟与常规护理的平行组随机试验。主要终点是无烟草患者的比例。次要结局在 6 个月和 12 个月随访时分别为：（i）连续 30 天吸烟戒断；（ii）与基线相比，过去 7 天每日烟草消耗减少 50%或更多；和（iii）戒烟尝试次数。
共有 480 名患者被随机分配至干预组（n=262）或常规护理组（n=218）。意向治疗分析显示两组在主要和次要结局上无差异。干预组的戒烟率略有但无统计学意义的提高[相对风险（RR）=1.04，95%置信区间（CI）=0.58-1.87]在 6 个月时，而在 12 个月时则出现相反的观察结果（RR=0.86，95%CI=0.50-1.47）。次要结局也得到了类似的结果。方案分析增加了结果的规模。在接受咨询的 126 名吸烟者中，有 18 人接受了当地戒烟中心的访视和治疗，其中 12 人成功完成了治疗。
本研究结果表明，ED 不是 5A 咨询的合适环境。
