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难以触及还是力度不足?儿科住院患者戒烟项目的叙述性综述。

Hard to Reach or Just Not Enough? A Narrative Review of Inpatient Tobacco Cessation Programs in Pediatrics.

机构信息

Bloomberg Children's Center at the Johns Hopkins Hospital, Baltimore, MD 21287, USA.

Pediatric Pulmonary, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

出版信息

Int J Environ Res Public Health. 2021 Dec 20;18(24):13423. doi: 10.3390/ijerph182413423.

Abstract

Caregiver smoking is a significant risk factor for children with acute and chronic diseases. Hospitalization presents an opportunity to explore caregiver smoking as a modifiable risk factor during a time of crisis when the motivation to change could be heightened. To date, there has not been a published review on inpatient smoking cessation interventions in pediatrics that focus on supporting caregivers of hospitalized children. The goals of this review were to identify and assess the reach and efficacy of tobacco cessation strategies implemented across inpatient units in pediatrics and mother-baby units. This review also proposes clinical and research implications along with program-building recommendations that can help inform future practice in tobacco cessation. A narrative review of the literature identified 14 peer-reviewed studies that described smoking cessation interventions between 2002 and 2021. There were five randomized controlled trials, seven prospective studies, and one retrospective study. The primary kinds of interventions were counseling to heighten caregiver contemplation to quit ( = 12), provision of Nicotine Replacement Therapy (NRT) medications ( = 7), and follow-up with the local Quitline ( = 12). A diverse range of deliverers implemented interventions across studies. Variation in defining quit attempts along with tobacco reduction and cessation outcomes contributed to mixed findings across studies.

摘要

照顾者吸烟是儿童患急性和慢性疾病的一个重要危险因素。住院为探索照顾者吸烟这一可改变的危险因素提供了机会,因为在这个危机时刻,改变的动机可能会增强。迄今为止,还没有发表过一篇针对儿科住院患者的戒烟干预措施的综述,这些干预措施侧重于支持住院儿童的照顾者。本综述的目的是确定和评估在儿科住院病房和母婴病房实施的烟草戒断策略的覆盖范围和效果。本综述还提出了临床和研究意义以及方案建设建议,有助于为烟草戒断的未来实践提供信息。对文献的叙述性综述确定了 14 项描述 2002 年至 2021 年期间戒烟干预措施的同行评审研究。其中有五项随机对照试验、七项前瞻性研究和一项回顾性研究。主要的干预措施是咨询,以提高照顾者戒烟的思考(=12)、提供尼古丁替代疗法(NRT)药物(=7)和与当地戒烟热线(=12)保持联系。在研究中,不同的提供者实施了各种干预措施。由于对戒烟尝试以及烟草减少和戒烟结果的定义不同,导致研究结果存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4410/8708019/820a34ee509d/ijerph-18-13423-g001.jpg

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