Chen Kuan-Lun, Hsu Yun-Chen, Li Yi-Hsuan, Guo Fei-Ran, Tsai Jaw-Shiun, Cheng Shao-Yi, Huang Hsien-Liang
Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan, China.
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan, China.
Tob Induc Dis. 2025 Jan 31;23. doi: 10.18332/tid/200023. eCollection 2025.
It remains unclear whether shared decision-making (SDM) can help smoking cessation. This study aims to determine whether the SDM model increases the 24-week point abstinence rate and medication adherence rate for adult smokers.
This prospective cohort study, conducted between January 2019 and June 2021, enrolled 1268 adult smokers at the outpatient cessation clinic of a national medical center. SDM-integrated counseling was provided to those opting for the SDM cessation model, involving cessation educators and decision aids. Patients who declined the model received cessation medication. The self-reported 7-day point prevalence abstinence rate at week 24, medication adherence rate, and the proportion of participants agreeing to receive pharmacotherapy were measured.
Out of the 1268 participants, 1187 (93.6%) were included in the primary analysis. Of these, 610 (48%) opted for the SDM model. Participants in the SDM group used cessation medication more frequently (83.4% vs 71.9%, p<0.001) and exhibited higher medication adherence (39.1% vs 28.6%, p=0.04). Logistic regression analysis revealed that the SDM group did not demonstrate a significantly higher 7-day point abstinence rate at week 24 (OR=0.89; 95% CI: 0.68-1.15; p=0.37).
The SDM cessation model was positively associated with medication adherence and the proportion of participants using pharmacotherapies. However, the association of SDM with the 7-day point prevalence of abstinence at week 24 was not statistically significant. Longer follow-up studies are needed to understand the association of the SDM intervention with absolute abstinence.
共同决策（SDM）是否有助于戒烟尚不清楚。本研究旨在确定SDM模式是否能提高成年吸烟者24周的戒烟率和药物依从率。
这项前瞻性队列研究于2019年1月至2021年6月进行，在一家国家医疗中心的门诊戒烟诊所招募了1268名成年吸烟者。为选择SDM戒烟模式的患者提供整合了SDM的咨询服务，包括戒烟教育者和决策辅助工具。拒绝该模式的患者接受戒烟药物治疗。测量了第24周自我报告的7天点患病率戒烟率、药物依从率以及同意接受药物治疗的参与者比例。
在1268名参与者中，1187名（93.6%）被纳入主要分析。其中，610名（48%）选择了SDM模式。SDM组的参与者更频繁地使用戒烟药物（83.4%对71.9%，p<0.001），并且表现出更高的药物依从性（39.1%对28.6%，p=0.04）。逻辑回归分析显示，SDM组在第24周的7天点戒烟率没有显著更高（OR=0.89；95%CI：0.68-1.15；p=0.37）。
SDM戒烟模式与药物依从性以及使用药物治疗的参与者比例呈正相关。然而，SDM与第24周7天点戒烟患病率的关联在统计学上并不显著。需要进行更长时间的随访研究来了解SDM干预与绝对戒烟的关联。
