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一项以戒烟为目标的针对 homeless smokers 的随机对照试验中,吸烟量减少。

Smoking reduction among homeless smokers in a randomized controlled trial targeting cessation.

机构信息

University of Minnesota, Department of Health Policy and Management, Minneapolis, MN 55455, USA.

California Department of Public Health, Sacramento, CA, United States.

出版信息

Addict Behav. 2022 Oct;133:107373. doi: 10.1016/j.addbeh.2022.107373. Epub 2022 May 21.


DOI:10.1016/j.addbeh.2022.107373
PMID:35689905
Abstract

INTRODUCTION: Homeless populations have high rates of smoking and unique barriers to quitting. General cessation strategies have been unsuccessful in this population. Smoking reduction may be a good intermediate goal. We conducted a secondary analysis to identify predictors of smoking reduction in a cohort of homeless smokers enrolled in a 26-week randomized clinical trial (RCT) targeting smoking cessation. METHODS: Data are from an RCT comparing motivational interviewing counseling plus nicotine replacement therapy (NRT) to brief advice to quit (standard care) plus NRT among homeless smokers. Using bivariate analyses and multinomial logistic regression, we compared demographics, health and psychosocial variables, tobacco use, substance use, and NRT adherence among those who reported: quitting; reducing smoking by 50-99%; and not reducing smoking by 50%. RESULTS: Of 324 participants who completed 26-week follow-up, 18.8% and 63.9% self-reported quitting and reducing, respectively. Compared to those who did not reduce smoking, participants reporting reducing indicated higher baseline cigarette use (OR=1.08; CI:1.04-1.12) and menthol use (OR=2.24; CI:1.05-4.77). Compared to participants who reduced, participants reporting quitting were more likely to be male (OR=1.998; CI:1.00-3.98), experience more housing instability (OR=1.97; CI:1.08-3.59), indicate higher importance of quitting (OR=1.27; CI:1.041.55), have higher NRT adherence (OR=1.75; CI:1.00-3.06), and lower odds of reported illicit drug use (OR=0.48; CI:0.24-0.95). CONCLUSIONS: Over half of participants reduced smoking by at least 50%, indicating reduction is feasible among homeless smokers. Further research is required to understand the impact of reduction on future cessation attempts in homeless smokers. This study shows that reduction is achievable and may be a valid intermediate goal.

摘要

介绍:无家可归者的吸烟率很高,戒烟存在独特的障碍。一般的戒烟策略在这一人群中并不成功。减少吸烟可能是一个很好的中间目标。我们对一项针对无家可归吸烟者的 26 周随机临床试验(RCT)进行了二次分析,以确定该人群中减少吸烟的预测因素。

方法:数据来自一项 RCT,该 RCT 比较了动机访谈咨询加尼古丁替代疗法(NRT)与简短戒烟建议(标准护理)加 NRT 对无家可归吸烟者的效果。使用双变量分析和多项逻辑回归,我们比较了完成 26 周随访的 324 名参与者中报告:戒烟;减少 50-99%的吸烟量;以及减少 50%以下的吸烟量的人群中的人口统计学、健康和社会心理变量、烟草使用、物质使用和 NRT 依从性。

结果:在 324 名完成 26 周随访的参与者中,18.8%和 63.9%分别报告戒烟和减少吸烟。与未减少吸烟的参与者相比,报告减少吸烟的参与者基线吸烟量更高(OR=1.08;CI:1.04-1.12),使用薄荷醇的可能性更大(OR=2.24;CI:1.05-4.77)。与减少吸烟的参与者相比,报告戒烟的参与者更有可能是男性(OR=1.998;CI:1.00-3.98),经历更多的住房不稳定(OR=1.97;CI:1.08-3.59),表示戒烟的重要性更高(OR=1.27;CI:1.041.55),NRT 依从性更高(OR=1.75;CI:1.00-3.06),报告非法药物使用的可能性更低(OR=0.48;CI:0.24-0.95)。

结论:超过一半的参与者减少了至少 50%的吸烟量,这表明无家可归的吸烟者减少吸烟是可行的。需要进一步研究了解减少吸烟对无家可归吸烟者未来戒烟尝试的影响。本研究表明,减少吸烟是可以实现的,可能是一个有效的中间目标。

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本文引用的文献

[1]
Interventions to increase adherence to medications for tobacco dependence.

Cochrane Database Syst Rev. 2019-8-16

[2]
Accuracy of self-reported smoking abstinence in clinical trials of hospital-initiated smoking interventions.

Addiction. 2017-8-23

[3]
Health, Secondhand Smoke Exposure, and Smoking Behavior Impacts of No-Smoking Policies in Public Housing, Colorado, 2014-2015.

Prev Chronic Dis. 2016-10-20

[4]
Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study.

Nicotine Tob Res. 2016-8

[5]
Smoke-free multiunit housing: a review of the scientific literature.

Tob Control. 2016-1

[6]
Comparing homeless smokers to economically disadvantaged domiciled smokers.

Am J Public Health. 2013-10-22

[7]
The effectiveness of cigarette price and smoke-free homes on low-income smokers in the United States.

Am J Public Health. 2013-10-17

[8]
Motivational interviewing to enhance nicotine patch treatment for smoking cessation among homeless smokers: a randomized controlled trial.

Addiction. 2013-3-19

[9]
Smoking characteristics and comorbidities in the power to quit randomized clinical trial for homeless smokers.

Nicotine Tob Res. 2012-5-15

[10]
Addressing smoking and other health risk behaviours using a novel telephone-delivered intervention for homeless people: a proof-of-concept study.

Drug Alcohol Rev. 2012-4-4

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