Daughton D, Susman J, Sitorius M, Belenky S, Millatmal T, Nowak R, Patil K, Rennard S I
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA.
Arch Fam Med. 1998 Sep-Oct;7(5):425-30. doi: 10.1001/archfami.7.5.425.
To evaluate the smoking cessation efficacy of nicotine patch therapy as an adjunct to low-intensity, primary care intervention.
Randomized, placebo-controlled, double-blind, multisite trial.
Twenty-one primary care sites in Nebraska.
A total of 369 smokers of 20 or more cigarettes per day.
Two brief primary care visits for smoking intervention with 10 weeks of active or placebo-patch therapy.
Confirmed self-reported abstinence 3, 6, and 12 months after the quit day.
Compared with placebo control subjects, participants assigned nicotine patches had higher 3-month (23.4% vs 11.4%; P < .01) and 6-month (18.5% vs 10.3%; P < .05) abstinence rates. The 1-year abstinence rates for the active and placebo patch groups were 14.7% and 8.7%, respectively (P = .07). Of smokers aged 45 years and older, 9 (18.8%) of 48 using active patches compared with 0 of 31 using placebo patches achieved 12-month abstinence (chi 2 = 6.56; P < .05). Among those with high nicotine dependency scores (Fagerstrom score > or = 7), 1-year abstinence rates were significantly higher in the nicotine patch group (19.1%) compared with the placebo group (5.0%) (chi 2 = 10.7; P = .001). However, there was no significant difference in 1-year quit rates for participants with low Fagerstrom scores (< 7).
Nicotine patch therapy enhanced 6 month quit rates as an adjunct to brief primary care intervention. The highest quit rates were achieved by participants who specifically contacted the site to enroll in the study or to obtain a prescription for nicotine patches. Differences in participant selection factors may account, in part, for the lower smoking cessation rates associated with primary care intervention. Duration of counseling, patient age, and Fagerstrom scores may be important factors related to the long-term smoking cessation success of nicotine patch therapy.
评估尼古丁贴片疗法作为低强度初级保健干预辅助手段的戒烟效果。
随机、安慰剂对照、双盲、多中心试验。
内布拉斯加州的21个初级保健机构。
共有369名每天吸烟20支及以上的吸烟者。
进行两次简短的初级保健机构戒烟干预门诊，并接受为期10周的活性或安慰剂贴片治疗。
戒烟日之后3个月、6个月和12个月时经确认的自我报告戒烟情况。
与安慰剂对照组相比，使用尼古丁贴片的参与者3个月（23.4%对11.4%；P<.01）和6个月（18.5%对10.3%；P<.05）的戒烟率更高。活性贴片组和安慰剂贴片组的1年戒烟率分别为14.7%和8.7%（P = .07）。年龄在45岁及以上的吸烟者中，48名使用活性贴片者中有9名（18.8%）实现了12个月戒烟，而31名使用安慰剂贴片者中无人实现（χ2 = 6.56；P<.05）。在尼古丁依赖评分较高（法格斯特龙评分≥7）的人群中，尼古丁贴片组的1年戒烟率（19.1%）显著高于安慰剂组（5.0%）（χ2 = 10.7；P = .001）。然而，法格斯特龙评分较低（<7）的参与者1年戒烟率无显著差异。
尼古丁贴片疗法作为简短初级保健干预的辅助手段可提高6个月戒烟率。通过专门联系研究机构登记参与研究或获取尼古丁贴片处方的参与者实现了最高戒烟率。参与者选择因素的差异可能部分解释了与初级保健干预相关的较低戒烟率。咨询时长、患者年龄以及法格斯特龙评分可能是与尼古丁贴片疗法长期戒烟成功相关的重要因素。
