Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
Wilford Hall Ambulatory Surgical Center, Clinical Health Psychology, Joint Base San Antonio - Lackland, San Antonio, TX, USA.
Nicotine Tob Res. 2023 Aug 23;25(10):1633-1640. doi: 10.1093/ntr/ntad085.
We sought to determine what type of treatment reengagement after smoking relapse would increase long-term cessation.
Participants were military personnel, retirees, and family members (TRICARE beneficiaries) recruited across the United States from August 2015 through June 2020. At baseline, consented participants (n = 614) received a validated, four-session, telephonic tobacco-cessation intervention with free nicotine replacement therapy. At the 3-month follow-up, 264 participants who failed to quit or relapsed were offered the opportunity to reengage in cessation. Of these, 134 were randomized into three reengagement conditions: (1) repeat initial intervention ("recycle"), (2) Smoking reduction with eventual cessation goal ("rate reduction"), or (3) Choose #1 or #2 ("choice"). Prolonged abstinence and 7-day point prevalence abstinence were measured at 12 months.
Despite being in a clinical trial advertised as having the opportunity for reengagement, only 51% (134 of the 264) of participants who still smoked at 3-month follow-up were willing to reengage. Overall, participants randomized to recycle had higher prolonged cessation rates at 12 months than rate reduction conditions (OR = 16.43, 95% CI: 2.52 to 107.09, Bonferroni adjusted p = .011). When participants who randomly received recycle or rate reduction were pooled, respectively, with participants who chose recycle or rate reduction in the Choice group, recycle had higher prolonged cessation rates at 12 months than rate reduction (OR = 6.50, 95% CI: 1.49 to 28.42, p = .013).
Our findings suggest service members and their family members who fail to quit smoking but are willing to reengage in a cessation program are more likely to benefit from repeating the same treatment.
Finding methods that are both successful and acceptable to reengage people who smoke who want to quit can have a significant impact on improving the health of the public by reducing the portion of the population who smoke. This study suggests that repeating established cessation programs will result in more people ready to quit successfully achieving their goal.
我们旨在确定哪种治疗方案能在复吸后增加长期戒烟率。
参与者为 2015 年 8 月至 2020 年 6 月期间在美国各地招募的军人、退休人员和家属（TRICARE 受益人）。在基线时，同意参与的（n=614）参与者接受了一项经过验证的、四次电话戒烟干预，同时提供免费尼古丁替代治疗。在 3 个月随访时，264 名未能戒烟或复吸的参与者有机会重新参与戒烟。其中，134 名被随机分为三种重新参与条件：（1）重复初始干预（“回收”），（2）逐步减少吸烟量以实现最终戒烟目标（“减少量”），或（3）选择（1）或（2）（“选择”）。12 个月时测量长期戒烟和 7 天点流行率戒烟。
尽管这是一项在临床试验中宣传的有重新参与机会的试验，但在 3 个月随访时仍吸烟的 264 名参与者中，只有 51%（134 名）愿意重新参与。总的来说，与减少量条件相比，随机分配到回收的参与者在 12 个月时有更高的长期戒烟率（OR=16.43，95%CI：2.52 至 107.09，Bonferroni 调整后 p=0.011）。当将随机接受回收或减少量的参与者分别与选择回收或减少量的参与者在选择组中进行汇总时，回收在 12 个月时的长期戒烟率高于减少量（OR=6.50，95%CI：1.49 至 28.42，p=0.013）。
我们的研究结果表明，未能戒烟但愿意重新参与戒烟计划的军人及其家属更有可能从重复相同治疗中获益。
找到既成功又能重新吸引想戒烟的吸烟者的方法，对于减少吸烟人群比例，从而提高公众健康水平具有重要意义。本研究表明，重复使用已建立的戒烟方案将使更多准备成功戒烟的人实现目标。
