Vojjala Mahathi, Wysota Christina N, Oketunbi Ololade, King Quiann, Rogers Erin S
NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA.
NYU School of Global Public Health, New York, NY, USA.
J Smok Cessat. 2023 Jul 22;2023:8165232. doi: 10.1155/2023/8165232. eCollection 2023.
People with mental health conditions (MHCs) are less likely to achieve long-term abstinence than people without MHCs. The Quit and Stay Quit Monday () model offers a long-term approach to treating tobacco use by encouraging people to quit, requit, or recommit to quit smoking every Monday.
To evaluate the efficacy, patient satisfaction, and patient engagement with an intervention that integrated the model into multicomponent smoking cessation services among people with an MHC.
This was a randomized controlled pilot trial. Eligibility criteria were as follows: (1) ≥18 years old, (2) smoked a cigarette in the past 30 days, (3) diagnosis of an ICD-10 MHC, (4) interest in quitting smoking, (5) able to receive services in English, and (5) had an active email and a cell phone. The intervention group ( = 33) received -focused telephone coaching, a weekly email newsletter, a SmokefreeTXT anchored around a Monday quit date, and 4 weeks of nicotine replacement therapy (NRT). The control group ( = 36) received information about contacting their state Quitline for usual services. Primary outcomes were self-reported quit attempts, 7-day abstinence, and intervention satisfaction at 3 months.
Twenty-four participants (73%) in the intervention group began telephone coaching, 26 (79%) enrolled in the email newsletter, 19 (58%) enrolled in SmokefreeTXT, and 15 (46%) used NRT. Using a penalized intent-to-treat approach, quit attempts in the intervention and control groups were 63.6% and 38.9% (OR 2.75, 95% CI 1.03-7.30), respectively. Seven-day abstinence in the two groups was 12.1% and 5.6% (OR 2.35, 95% CI 0.40-13.74), respectively. Of the 15 intervention group participants who set a quit date during the intervention, 13 (86.7%) selected a Monday quit day. Qualitative interviews revealed positive participant experiences with picking a Monday quit day. On follow-up surveys, 89.5%, 69.3%, and 64.3% of intervention participants reported that the counseling, email, and text messaging, respectively, were very or somewhat helpful.
The model was acceptable and potentially efficacious among people with MHCs, but intervention engagement and satisfaction were modest. Future research should adapt or develop new delivery approaches to improve patient engagement and potential efficacy of the model. This trial is registered with clinicaltrials.gov (NCT04512248).
患有心理健康问题（MHCs）的人比没有心理健康问题的人更难实现长期戒烟。“周一戒烟并保持戒烟状态（Quit and Stay Quit Monday，简称QSM）”模式提供了一种长期治疗烟草使用的方法，鼓励人们每周一戒烟、重新戒烟或再次承诺戒烟。
评估将QSM模式整合到针对患有MHCs的人群的多成分戒烟服务中的干预措施的疗效、患者满意度和患者参与度。
这是一项随机对照试验性研究。纳入标准如下：（1）年龄≥18岁；（2）在过去30天内吸过烟；（3）诊断为国际疾病分类第10版（ICD - 10）中的心理健康问题；（4）有戒烟意愿；（5）能够接受英语服务；（6）有有效的电子邮件和手机。干预组（n = 33）接受以QSM为重点的电话辅导、每周一次的电子邮件通讯、围绕周一戒烟日期的无烟短信服务（SmokefreeTXT）以及4周的尼古丁替代疗法（NRT）。对照组（n = 36）收到有关联系其所在州戒烟热线获取常规服务的信息。主要结局指标为自我报告的戒烟尝试、7天戒烟率以及3个月时的干预满意度。
干预组中有24名参与者（73%）开始接受电话辅导，26名（79%）注册了电子邮件通讯，19名（58%）注册了无烟短信服务，15名（46%）使用了尼古丁替代疗法。采用惩罚性意向性分析方法，干预组和对照组的戒烟尝试率分别为63.6%和38.9%（比值比[OR] 2.75，95%置信区间[CI] 1.03 - 7.30）。两组的7天戒烟率分别为12.1%和5.6%（OR 2.35，95% CI 0.40 - 13.74）。在干预期间设定了戒烟日期的15名干预组参与者中，有13名（86.7%）选择了周一作为戒烟日。定性访谈揭示了参与者选择周一戒烟日的积极体验。在后续调查中，分别有89.5%、69.3%和64. ~ 3%的干预组参与者表示咨询、电子邮件和短信服务非常或有点帮助。
QSM模式在患有MHCs的人群中是可接受的且可能有效，但干预参与度和满意度一般。未来的研究应调整或开发新的QSM实施方法，以提高患者参与度和该模式的潜在疗效。本试验已在ClinicalTrials.gov注册（NCT04512248）。
