智能手机应用程序与书面材料对接受低剂量计算机断层扫描（LDCT）肺癌筛查的个体减少吸烟及戒烟的效果比较：一项II期开放标签随机对照试验

Smartphone application versus written material for smoking reduction and cessation in individuals undergoing low-dose computed tomography (LDCT) screening for lung cancer: a phase II open-label randomised controlled trial.

作者信息

Iivanainen Sanna, Kurtti Antti, Wichmann Viktor, Andersen Heidi, Jekunen Antti, Kaarteenaho Riitta, Vasankari Tuula, Koivunen Jussi P

机构信息

Cancer Center Oulu University Hospital, Finland.

University of Oulu, Finland.

出版信息

Lancet Reg Health Eur. 2024 May 25;42:100946. doi: 10.1016/j.lanepe.2024.100946. eCollection 2024 Jul.

DOI:10.1016/j.lanepe.2024.100946

PMID:39070744

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11281920/

Abstract

BACKGROUND

Counseling, nicotine replacement, and other cessation medications have been proven effective in smoking cessation. The wide-scale adoption of smartphones and other mobile devices has opened new possibilities for scalable and personalized smoking cessation approaches. The study investigated whether a smartphone application would be more effective than written material for smoking cessation and reduction in smoking in individuals undergoing low-dose computed tomography (LDCT) screening for lung cancer (NCT05630950).

METHODS

This randomized controlled trial enrolled 201 current smokers with marked smoking history (smoked ≥15 cigarettes/day for ≥25 years or smoked ≥10 cigarettes/day for ≥30 years). Participants were stratified by age and pack-years and randomized in 1:1 fashion to the developed smartphone application (experimental arm) or written material (standard of care). All the subjects underwent LDCT screening. Self-reported smoking cessation at three and six months were the primary endpoints of the study. The smoking-related secondary endpoints of the study were the percentage of individuals who had reduced the number of smoked cigarettes/d from the baseline.

FINDINGS

Between Nov 18, 2022, and Apr 14, 2023, 201 patients were screened at Oulu University Hospital, Finland, of whom all were randomly assigned to smartphone application (n = 101) or written cessation material (n = 100); 200 were included in the full analysis set. Study arms were well-balanced for all the studied demographic factors. Subjects randomized to the smartphone application arm had significantly higher rates for self-reported smoking cessation at three (19.8 versus 7.1%; OR 3.175 CI 95% 1.276-7.899) and six months (18.8 versus 7.1%; OR 2.847 CI 95% 1.137-7.128). In the experimental arm, individuals with a frequent use of the application had a higher chance for smoking cessation at three (p < 0.001) and six months (p = 0.003).

INTERPRETATION

The study showed that the developed smartphone application increases the likelihood for smoking cessation in individuals undergoing lung cancer LDCT screening.

FUNDING

AstraZeneca, Roche, and Cancer Foundation Finland.

摘要

背景

咨询、尼古丁替代疗法及其他戒烟药物已被证明对戒烟有效。智能手机和其他移动设备的广泛应用为可扩展且个性化的戒烟方法带来了新的可能性。本研究调查了对于接受低剂量计算机断层扫描（LDCT）肺癌筛查的个体，一款智能手机应用程序在戒烟及减少吸烟量方面是否比书面材料更有效（NCT05630950）。

方法

这项随机对照试验纳入了201名有显著吸烟史的当前吸烟者（每天吸烟≥15支，持续≥25年；或每天吸烟≥10支，持续≥30年）。参与者按年龄和吸烟包年数分层，并以1:1的比例随机分配至开发的智能手机应用程序组（试验组）或书面材料组（对照标准）。所有受试者均接受了LDCT筛查。研究的主要终点是三个月和六个月时自我报告的戒烟情况。研究的吸烟相关次要终点是与基线相比，减少每日吸烟量的个体百分比。

结果

在2022年11月18日至2023年4月14日期间，芬兰奥卢大学医院对201名患者进行了筛查，所有患者均被随机分配至智能手机应用程序组（n = 101）或书面戒烟材料组（n = 100）；200名患者被纳入全分析集。在所有研究的人口统计学因素方面，各研究组之间均衡良好。随机分配至智能手机应用程序组的受试者在三个月（19.8%对7.1%；比值比3.175，95%置信区间1.276 - 7.899）和六个月（18.8%对7.1%；比值比2.847，95%置信区间1.137 - 7.128）时自我报告的戒烟率显著更高。在试验组中，频繁使用该应用程序的个体在三个月（p < 0.001）和六个月（p = 0.003）时戒烟的可能性更高。