Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Penn State Cancer Institute, Hershey, Pennsylvania, USA.
Psychooncology. 2023 Aug;32(8):1147-1162. doi: 10.1002/pon.6171. Epub 2023 May 24.
Continued smoking after cancer diagnosis is associated with worse outcomes, however, many persons diagnosed with cancer who smoke are unable to quit successfully. Effective interventions are needed to promote quitting in this population. The purpose of this systematic review is to understand the most effective interventions for smoking cessation among persons with cancer and to identify gaps in knowledge and methodology to suggest directions for future research.
Three electronic databases (The Cochrane Central Register of Controlled trials, MEDLINE, and EMBASE) were searched for studies of smoking cessation interventions among persons with cancer, published up to 1 July 2021. Title and abstract screening, full-text review, and data extraction was completed by two independent reviewers, via Covalence software, with any discordance resolved by a third reviewer. A quality assessment was completed using the Cochrane Risk of Bias Tool Version 2.
Thirty-six articles were included in the review, including 17 randomized-controlled trials (RCTs) and 19 non-RCT studies. Of the 36 studies, 28 (77.8%) utilized an intervention that included both counseling and medication, with 24 (85.7%) providing medication to participants at no cost. Abstinence rates in the RCT intervention groups (n = 17) ranged from 5.2% to 75%, while the non-RCTs found abstinence rates ranging from 15% to 46%. Overall, studies met a mean of 2.28 out of seven quality items, ranging from 0 to 6.
Our study highlights the importance of utilizing intensive combined behavioral and pharmacological interventions for persons with cancer. While combined therapy interventions seem to be the most effective, more research is needed, as current studies have several quality issues, including the lack of biochemical verification for abstinence.
癌症诊断后继续吸烟与预后更差相关，然而，许多吸烟的癌症患者无法成功戒烟。需要有效的干预措施来促进这一人群戒烟。本系统评价的目的是了解癌症患者戒烟最有效的干预措施，并确定知识和方法上的差距，为未来的研究提出方向。
截至 2021 年 7 月 1 日，我们在三个电子数据库（Cochrane 对照试验中心注册库、MEDLINE 和 EMBASE）中搜索了针对癌症患者的戒烟干预措施的研究。两名独立审查员通过 Covalence 软件完成标题和摘要筛选、全文审查和数据提取，如果出现分歧，则由第三名审查员解决。使用 Cochrane 偏倚风险工具版本 2 对质量进行评估。
共纳入 36 篇文章，包括 17 项随机对照试验（RCT）和 19 项非 RCT 研究。在 36 项研究中，28 项（77.8%）采用了包括咨询和药物治疗在内的干预措施，其中 24 项（85.7%）向参与者免费提供药物。RCT 干预组的戒烟率（n=17）范围为 5.2%至 75%，而非 RCT 研究的戒烟率范围为 15%至 46%。总体而言，研究在 7 项质量指标中平均达到 2.28 项，范围为 0 至 6 项。
我们的研究强调了对癌症患者采用强化联合行为和药物治疗干预措施的重要性。虽然联合治疗干预措施似乎最有效，但还需要更多的研究，因为目前的研究存在几个质量问题，包括缺乏对戒烟的生化验证。
