Department of Health Sciences and Closing the Gap Network, University of York, York, UK.
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Addiction. 2022 Jun;117(6):1526-1542. doi: 10.1111/add.15724. Epub 2021 Nov 6.
People with severe mental ill health smoke more and suffer greater smoking-related morbidity and mortality. Little is known about the effectiveness of behavioural interventions for smoking cessation in this group. This review evaluated randomized controlled trial evidence to measure the effectiveness of behavioural smoking cessation interventions (both digital and non-digital) in people with severe mental ill health.
Systematic review and random-effects meta-analysis. We searched between inception and January 2020 in Medline, EMBASE, PsycINFO, CINAHL, Health Management Information Consortium and CENTRAL databases.
Randomized controlled trials (RCTs) assessing the effects of behavioural smoking cessation and reduction interventions in adults with severe mental ill health, conducted in any country, in either in-patient or community settings and published in English.
The primary outcome was biochemically verified smoking cessation. Smoking reduction and changes in mental health symptoms and body mass index (BMI) were included as secondary outcomes. Narrative data synthesis and meta-analysis were conducted and the quality of included studies was appraised using the risk of bias 2 (RoB2) tool.
We included 12 individual studies (16 articles) involving 1861 participants. The first meta-analysis (three studies, 921 participants) demonstrated effectiveness of bespoke face-to-face interventions compared with usual care across all time-points [medium-term: relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.38-3.81; long-term: RR = 1.58, 95% CI = 1.09-2.30]. The second (three studies, 275 participants) did not demonstrate any difference in effectiveness of bespoke digital on-line interventions compared with standard digital on-line interventions (medium-term: RR = 0.87, 95% CI = 0.17-4.46). A narrative overview revealed mixed results when comparing bespoke face-to-face interventions with other active interventions. The methodological quality of studies was mixed, with the majority having some concerns mainly around risk of selective reporting.
Face-to-face bespoke smoking cessation interventions for adults with severe mental ill health appear to be effective when compared with treatment as usual, but evidence is equivocal when compared with other active interventions. There is limited evidence comparing bespoke digital interventions with generic interventions, and we found no studies comparing them with usual treatment.
患有严重精神疾病的人群吸烟更多，且面临更大的与吸烟相关的发病率和死亡率。对于针对该人群的戒烟行为干预措施的有效性，我们知之甚少。本综述评估了随机对照试验证据，以衡量严重精神疾病患者的行为戒烟干预措施（包括数字和非数字干预措施）的有效性。
系统评价和随机效应荟萃分析。我们在 Medline、EMBASE、PsycINFO、CINAHL、Health Management Information Consortium 和 CENTRAL 数据库中检索了从开始到 2020 年 1 月的文献。
评估行为戒烟和减少干预措施对严重精神疾病成年人影响的随机对照试验（RCTs），这些试验在任何国家进行，在住院或社区环境中进行，且以英文发表。
主要结局是通过生物化学方法验证的戒烟。作为次要结局，还纳入了吸烟减少以及心理健康症状和体重指数（BMI）的变化。进行了叙述性数据综合和荟萃分析，并使用偏倚风险 2（RoB2）工具评估了纳入研究的质量。
我们纳入了 12 项单独的研究（16 篇文章），涉及 1861 名参与者。第一项荟萃分析（三项研究，921 名参与者）表明，与常规护理相比，定制的面对面干预措施在所有时间点都有效[中期：相对风险（RR）=2.29，95%置信区间（CI）=1.38-3.81；长期：RR=1.58，95%CI=1.09-2.30]。第二项（三项研究，275 名参与者）表明，定制的数字在线干预措施与标准的数字在线干预措施之间没有显示出任何效果差异[中期：RR=0.87，95%CI=0.17-4.46]。叙述性综述结果显示，当将定制的面对面干预措施与其他积极干预措施进行比较时，结果各不相同。研究的方法学质量参差不齐，大多数研究主要存在选择报告的风险方面的一些问题。
与常规治疗相比，针对严重精神疾病成年人的面对面定制戒烟干预措施似乎有效，但与其他积极干预措施相比，证据尚不确定。比较定制数字干预措施与通用干预措施的证据有限，我们没有发现比较它们与常规治疗的研究。
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