Clinical Health Promotion Centre (WHO-CC), the Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of Copenhagen University Hospital, Frederiksberg, Denmark
Clinical Health Promotion Centre (WHO-CC), Department of Health Sciences, Lund University, Lund, Sweden.
Eur Respir Rev. 2022 Aug 23;31(165). doi: 10.1183/16000617.0063-2022. Print 2022 Sep 30.
To evaluate the efficacy of intensive smoking cessation interventions (ISCIs) directly compared with shorter interventions (SIs), measured as successful quitting.
Medline, Embase, the Cochrane Library and CINAHL were searched on 15 October 2021. Peer-reviewed randomised controlled trials (RCTs) of adult, daily smokers undergoing an ISCI were included. No setting, time or language restrictions were imposed. Risk of bias and quality of evidence was assessed using the Cochrane tool and Grading of Recommendations, Assessment, Development and Evaluation, respectively. Meta-analyses were conducted using a random-effects model.
17 550 unique articles were identified and 17 RCTs evaluating 9812 smokers were included. 14 studies were conducted in Europe or the USA. The quality of the evidence was assessed as low or moderate. Continuous abstinence was significantly higher in ISCIs in the long term (risk ratio 2.60, 95% CI 1.71-3.97). Direction and magnitude were similar in the short term; however, they were not statistically significant (risk ratio 2.49, 95% CI: 0.94-6.56). When measured as point prevalence, successful quitting was still statistically significant in favour of ISCIs, but lower (long term: 1.64, 1.08-2.47; short term: 1.68, 1.10-2.56). Sensitivity analysis confirmed the robustness of the results.
ISCIs are highly effective compared to SIs. This important knowledge should be used to avoid additional morbidity and mortality caused by smoking.
评估强化戒烟干预(ISCIs)与较短干预(SIs)的疗效,以成功戒烟为衡量标准。
于 2021 年 10 月 15 日检索 Medline、Embase、Cochrane 图书馆和 CINAHL 数据库。纳入接受 ISCI 的成年、每日吸烟者的随机对照试验(RCT)。未对研究场所、时间或语言进行限制。使用 Cochrane 工具评估偏倚风险,使用 Grading of Recommendations,Assessment,Development and Evaluation 评估证据质量。使用随机效应模型进行荟萃分析。
共识别出 17550 篇独特的文章,纳入了 17 项评估 9812 名吸烟者的 RCT。14 项研究在欧洲或美国进行。证据质量评估为低或中。长期来看,ISCIs 的持续戒烟率显著更高(风险比 2.60,95%CI 1.71-3.97)。短期来看,方向和幅度相似,但无统计学意义(风险比 2.49,95%CI:0.94-6.56)。当以点患病率衡量时,ISCIs 仍然具有统计学意义的优势,但优势较小(长期:1.64,1.08-2.47;短期:1.68,1.10-2.56)。敏感性分析证实了结果的稳健性。
ISCIs 与 SIs 相比非常有效。这一重要知识应被用于避免因吸烟导致的额外发病率和死亡率。