移动电话咨询戒烟干预措施对全国结核病控制规划中肺结核吸烟者戒烟效果的影响。

Efficacy of smoking cessation intervention delivered through mobile tele-counseling among smokers with tuberculosis in a Revised National Tuberculosis Control Program.

机构信息

Department of Pulmonary Medicine, Goa Medical College, Goa, India.

出版信息

Indian J Tuberc. 2022 Apr;69(2):207-212. doi: 10.1016/j.ijtb.2021.08.017. Epub 2021 Aug 17.

DOI:10.1016/j.ijtb.2021.08.017

PMID:35379403

Abstract

BACKGROUND

India has high burden of tuberculosis and smokers. Prevalence of tuberculosis is three times higher in smokers than non-smokers. Active smoking causes severe disease, delay in seeking treatment, lost to treatment follow up, delayed sputum conversion and drug resistance. WHO advocates mobile phone technology to improve health outcomes (mHealth). We used mobile tele-counseling as a smoking cessation intervention in smokers with tuberculosis (TB) receiving treatment under tuberculosis control program.

AIM

To determine smoking quit rate at six months of TB treatment among smokers receiving mobile tele-counseling versus brief advice and to estimate smoking quit rates and relapse rates during the tele-counseling period.

METHODS

Open label randomized controlled trial. Newly detected pulmonary tuberculosis or pleural effusion patients received brief advice on smoking cessation as per The UNION's guiding framework. Subjects were then randomly allocated to intervention or control group. Intervention group was contacted telephonically at 2,3,4,5 and 6 months to assess smoking quit rates and provide continued smoking cessation advice.

RESULTS

Intervention group had 80 and 82 in the control group, mean (SD) age was 40.6(12.6), 43.5(12.7) p = 0.53. Quit rate at six months was 54 (67.5%) in intervention group versus 34 (42%) in control group; RR 1.60 (95% CI 1.19, 2.16) p = 0.001. Trend in smoking quit rates in intervention group was 81.3%, 61.3%, 55%, 73.8% at 2,3,4 and 5 months respectively. Smoking relapse rate was 43.1%, 53.1%, 20.5%,15.3% at 3,4,5 and 6 months respectively. 27.5%, 43.8% were abstinent for last three, two months.

CONCLUSIONS

Mobile tele-counseling is an effective strategy for smoking cessation among TB patients.

摘要

背景

印度的结核病和吸烟者负担沉重。与不吸烟者相比，吸烟者结核病的患病率高出三倍。主动吸烟会导致病情加重、治疗延迟、治疗随访失败、痰培养转阴延迟和耐药。世界卫生组织提倡利用移动电话技术改善健康结果（移动医疗）。我们在结核病控制规划下接受治疗的肺结核（TB）吸烟者中使用移动电话咨询作为戒烟干预措施。

目的

确定接受移动电话咨询的吸烟者在接受结核病治疗的六个月内的戒烟率，以及估计在咨询期间的戒烟率和复吸率。

方法

开放标签随机对照试验。新发现的肺结核或胸腔积液患者按照《联合国》指导框架接受简短的戒烟建议。然后将患者随机分配到干预组或对照组。干预组在 2、3、4、5 和 6 个月时通过电话联系，评估戒烟率并提供持续的戒烟建议。

结果

干预组有 80 人，对照组有 82 人，平均（SD）年龄分别为 40.6（12.6）、43.5（12.7），p=0.53。干预组在六个月时的戒烟率为 54（67.5%），而对照组为 34（42%）；RR 1.60（95% CI 1.19，2.16），p=0.001。干预组的戒烟率趋势在 2、3、4 和 5 个月时分别为 81.3%、61.3%、55%、73.8%。在 3、4、5 和 6 个月时的复吸率分别为 43.1%、53.1%、20.5%、15.3%。在过去的三个月和两个月中，分别有 27.5%和 43.8%的人保持了禁欲。