Nagasawa Tomomi, Saito Junko, Odawara Miyuki, Kaji Yuki, Yuwaki Keiichi, Imamura Haruhiko, Nogi Kazuya, Nakamura Masakazu, Shimazu Taichi
Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan.
Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan.
Implement Sci Commun. 2023 Nov 22;4(1):146. doi: 10.1186/s43058-023-00517-0.
Smoking is the leading risk factor for death worldwide. In Japan, although several evidence-based interventions (EBIs) for smoking cessation have been disseminated or adopted, there is a gap between scientific evidence and the actual implementation. This scoping review aimed to describe the knowledge gaps in local-level smoking cessation interventions in Japan, their implementation outcomes, implementation barriers and facilitators, and the use of implementation strategies.
This study comprised two approaches: (1) a comprehensive scoping review of primary and grey literature, and (2) a supplemental survey of organizations in the grey literature. For the scoping review, we included original studies or reports on smoking cessation interventions targeting adults aged 18 years and older, or providers of cessation support at various settings (community, workplace, school, and clinical settings) in Japan. The extracted data included basic characteristics, intervention categories, implementation outcomes, factors influencing implementation, and implementation strategies for each intervention. Responses to the supplemental survey were extracted same used for the scoping review. To gain a deeper understanding, semi-structured interviews were conducted with some of the organizations in the survey.
A total of 600 interventions with 691 intervention components, based on EBIs in the 2020 US Surgeon General Report, from 498 articles were included in the data extraction; 32 of the 88 organizations responded to the survey. Regarding the overall knowledge about smoking cessation intervention components, behavioral counseling, and cessation medication in clinical settings were mostly reported (34.7%). Implementation outcomes were measured in 18 articles (3.0%) and penetration was mostly reported. Regarding influential factors, "available resources," and "knowledge and beliefs about the intervention" for barriers, and "relative priority" for facilitators were mostly reported. Implementation strategies were measured in 29 articles (4.8%), and "Train and educate stakeholders" was mostly reported.
Most EBIs reported in the Japanese literature included smoking cessation treatments in clinical settings. While a few articles focused on the implementation indicators in Japan, significant knowledge and experience were extracted from the grey literature, especially in the workplace and community settings. Future research should focus more on implementation to reduce the knowledge gap regarding smoking cessation interventions.
吸烟是全球范围内导致死亡的主要风险因素。在日本，尽管已经传播或采用了几种基于证据的戒烟干预措施，但科学证据与实际实施之间仍存在差距。本范围综述旨在描述日本地方层面戒烟干预措施中的知识差距、实施结果、实施障碍和促进因素，以及实施策略的使用情况。
本研究包括两种方法：（1）对原始文献和灰色文献进行全面的范围综述，（2）对灰色文献中的组织进行补充调查。对于范围综述，我们纳入了针对18岁及以上成年人的戒烟干预措施的原始研究或报告，或日本各种场所（社区、工作场所、学校和临床场所）的戒烟支持提供者。提取的数据包括每项干预措施的基本特征、干预类别、实施结果、影响实施的因素和实施策略。对补充调查的回复提取方式与范围综述相同。为了更深入地了解情况，对调查中的一些组织进行了半结构化访谈。
在数据提取中纳入了基于2020年美国卫生局局长报告中的循证干预措施的498篇文章中的600项干预措施和691个干预组成部分；88个组织中有32个回复了调查。关于戒烟干预组成部分的总体知识，临床环境中的行为咨询和戒烟药物报道最多（34.7%）。18篇文章（3.0%）测量了实施结果，其中渗透率报道最多。关于影响因素，障碍方面“可用资源”和“对干预的知识和信念”，促进因素方面“相对优先级”报道最多。29篇文章（4.8%）测量了实施策略，其中“培训和教育利益相关者”报道最多。
日本文献中报道的大多数循证干预措施包括临床环境中的戒烟治疗。虽然少数文章关注日本的实施指标，但从灰色文献中提取了重要的知识和经验，特别是在工作场所和社区环境中。未来的研究应更多地关注实施，以缩小戒烟干预措施方面的知识差距。
