Jin Xingzhong, Kinner Stuart Alistair, Hopkins Robyn, Stockings Emily, Courtney Ryan James, Shakeshaft Anthony, Petrie Dennis, Dobbins Timothy, Puljevic Cheneal, Chang Shuai, Dolan Kate
Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
Int J Prison Health. 2021 Nov 17;17(4):462-476. doi: 10.1108/IJPH-01-2020-0003.
This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.
DESIGN/METHODOLOGY/APPROACH: This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45-60 min) face-to-face MI intervention 4-6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.
From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI ( = 266) or UC ( = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release ( < 0.01).
RESEARCH LIMITATIONS/IMPLICATIONS: A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.
ORIGINALITY/VALUE: This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.
本文旨在确定单次动机性访谈（MI）是否能减少从无烟监狱释放人员的吸烟复发情况。
设计/方法/途径：本研究试图从澳大利亚北领地的两所无烟监狱招募824名前吸烟者。参与者被随机分为两组，一组在释放前4 - 6周接受一次（45 - 60分钟）面对面的MI干预，另一组接受无吸烟建议的常规护理（UC）。主要结局是通过释放后三个月的呼出一氧化碳测试（<5 ppm）验证的持续戒烟情况。次要结局包括七天点患病率、首次吸烟时间以及释放后每日吸烟量。
2017年4月至2018年3月，共有557名参与者被随机分组接受MI（n = 266）或UC（n = 291），随访率分别为75%和77%。持续戒烟情况在组间无显著差异（MI组为8.6%，UC组为7.4%，风险比 = 1.16，95%CI 0.67 ∼ 2.03）。所有参与者中，66.9%在释放当天复发，90.2%在三个月内复发。释放后三个月内，MI组参与者平均每天比UC组少吸一支烟（P < 0.01）。
研究局限性/启示：单次MI不足以减少从无烟监狱释放后的复发情况。然而，监狱释放仍是一个利用无烟监狱公共卫生效益的有吸引力的时间窗口。需要进一步研究开发释放前和释放后的干预措施，以提供预防复发的连续性护理。
原创性/价值：本研究是澳大利亚首个评估释放前MI干预对无烟监狱释放人员预防吸烟复发效果的随机对照试验。
