Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
Department of Internal Medicine, University of South Alabama, Mobile, Alabama, United States of America.
PLoS One. 2022 Dec 15;17(12):e0279065. doi: 10.1371/journal.pone.0279065. eCollection 2022.
Smoking rates among patients with rheumatoid arthritis (RA) exceed those in the general population. This study identified smoking cessation strategies used in patients with RA and synthesized data on their effects.
We conducted a systematic review of studies that reported effects of interventions for smoking cessation in patients with RA. We searched 5 electronic databases until March 2022. Screening, quality appraisal, and data collection were done independently by 2 reviewers.
We included 18 studies reporting interventions for patients or providers: 14 evaluated strategies for patients (5 education on cardiovascular risk factors including smoking, 3 educational interventions on smoking cessation alone, 3 education with nicotine replacement and counseling, and 1 study each: education with nicotine replacement, counseling sessions alone, and a social marketing campaign). Smoking cessation rates ranged from 4% (95% CI: 2%-6%, 24 to 48 weeks) for cardiovascular risk education to 43% (95% CI: 21%-67%, 104 weeks) for counseling sessions alone. The pooled cessation rate for all interventions was 22% (95% CI: 8%-41%, 4 weeks to 104 weeks; 9 studies). Four interventions trained providers to ascertain smoking status and provide referrals for smoking cessation. The pooled rates of referrals to quit services increased from 5% in pre-implementation populations to 70% in post-implementation populations.
Studies varied in patient characteristics, the interventions used, and their implementation structure. Only 3 studies were controlled clinical trials. Additional controlled studies are needed to determine best practices for smoking cessation for patients with RA.
类风湿关节炎（RA）患者的吸烟率高于普通人群。本研究确定了 RA 患者中使用的戒烟策略，并综合了这些策略的效果数据。
我们对报告 RA 患者戒烟干预效果的研究进行了系统评价。我们在 2022 年 3 月前在 5 个电子数据库中进行了检索。筛查、质量评估和数据收集由 2 名评审员独立进行。
我们纳入了 18 项报告针对患者或提供者的干预措施的研究：14 项评估了针对患者的策略（5 项心血管危险因素教育，包括吸烟，3 项单独的戒烟教育，3 项尼古丁替代和咨询教育，以及各 1 项研究：尼古丁替代教育，单独咨询和社会营销活动）。戒烟率从心血管风险教育的 4%（95%CI：2%-6%，24-48 周）到单独咨询的 43%（95%CI：21%-67%，104 周）不等。所有干预措施的总戒烟率为 22%（95%CI：8%-41%，4 周至 104 周；9 项研究）。有 4 项干预措施培训提供者确定吸烟状况并为戒烟提供转诊。转诊戒烟服务的比例从实施前人群的 5%增加到实施后人群的 70%。
研究在患者特征、干预措施及其实施结构方面存在差异。只有 3 项研究是对照临床试验。需要更多的对照研究来确定 RA 患者戒烟的最佳实践。
