Qiao Kun, Liu Han, Li Xingming, Jin Qianying, Wang Yao, Gu Mingyu, Bai Xinyuan, Qin Tingting, Yang Yutong
School of Public Health, Capital Medical University, Beijing, China.
Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Front Psychiatry. 2023 Mar 7;14:1029640. doi: 10.3389/fpsyt.2023.1029640. eCollection 2023.
To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention.
Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate.
Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, < 0.05) and 3rd month (reduced by 2.050, < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention.
The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.
评估烟草依赖的医院-社区综合管理模式与简短戒烟干预相比对社区居民戒烟的效果。
我们的研究在北京19个社区招募了651名愿意戒烟的吸烟者，并进行了为期6个月的戒烟干预。对照组接受简短戒烟干预，试验组接受综合戒烟干预。采用意向性分析（ITT）和广义估计方程来评估综合干预和戒烟药物对每日平均吸烟量（ACSD）和戒烟率的影响。
简单效应分析显示，随访时服用药物的吸烟者的ACSD显著低于未服用药物的吸烟者，对照组在第1、3和6个月分别减少吸烟3.270、4.830和4.760支，而试验组分别减少6.230、5.820和4.100支。综合干预在第1个月（减少3.420，<0.05）和第3个月（减少2.050，<0.05）显著降低了服用药物吸烟者的ACSD，但对未服用药物的吸烟者没有显著影响。服用药物吸烟者在第3个月的戒烟率为27.0%，显著高于接受简短戒烟干预的吸烟者。
医院-社区综合干预可显著促进服用药物吸烟者戒烟，但在推广之前应解决药物支付和医务人员额外劳动报酬的问题。
