一个控烟计划的长期结果
2010/01/07
背景：目前对于控烟措施的综合评价较缺乏，尤其在保健系统，在患者亚组关于控烟的花费、吸烟减少的保持、稳定的信息知之甚少。
方法：HMO组织招募的在门诊外科与诊断过程中的320个成人吸烟者的代表性样本随机入组到常规措施组与结合电话咨询和简报通讯的控烟干预组。分析吸烟量、一氧化碳水平、花费等结果。
结果：干预组和对照组都持续改善了3到12个月的效果评价。在12个月随访时使用意向-治疗分析评价两组间的自评报告和一氧化碳值差别均无统计学意义（吸烟量减少50%以上的比例分别为25% vs. 19%）。
结论：在缺乏尼古丁替代治疗的情况下，这种控烟措施的长期效果似乎不够显著。还需要进一步研究来提高干预效果、对项目变量进行更综合的分析。
（张永明编译 刘国梁审校）
Medical Care. 47(1):115-120, January 2009.
Long-Term Results of a Smoking Reduction Program.
Glasgow, Russell E. PhD *; Gaglio, Bridget MPH *; Estabrooks, Paul A. PhD *+; Marcus, Alfred C. PhD ++; Ritzwoller, Debra P. PhD *; Smith, Tammy L. BS ++; Levinson, Arnold H. PhD ++; Sukhanova, Anna MA *; O’Donnell, Colin MS ++; Ferro, Erica F. MA *; France, Eric K. MD *
From the *Kaiser Permanente, Denver, Colorado; +Virginia Polytechnic Institute and State University, Blacksburg, Virginia; and ++AMC Cancer Research Center, University of Colorado Denver Health Sciences Center, Denver, Colorado.
introduction: There have been few comprehensive evaluations of smoking reduction, especially in health care delivery systems, and little is known about its cost, maintenance of reduced smoking, or robustness across patient subgroups.
Methods: A generally representative sample of 320 adult smokers from an HMO scheduled for outpatient surgery or a diagnostic procedure was randomized to enhanced usual care or a theory-based smoking reduction intervention that combined telephone counseling and tailored newsletters. Outcomes included cigarettes smoked, carbon monoxide levels, and costs.
Results: Both intervention and control conditions continued to improve from 3- to 12-month assessments. Between-condition differences using intent-to-treat analyses on both self-report and carbon monoxide measures were nonsignificant by the 12-month follow-up (25% vs. 19% achieved 50% or greater reductions in cigarettes smoked). The intervention was implemented consistently despite logistical constraints and was generally robust across patient characteristics (eg, education, ethnicity, health literacy, dependence) .
Conclusions: In the absence of nicotine replacement therapy, the long-term effects of this smoking reduction intervention seem modest and nonsignificant. Future research is indicated to enhance intervention effects and conduct more comprehensive economic analyses of program variations.
DOI Number 10.1097/MLR.0b013e31817e18d1
方法：HMO组织招募的在门诊外科与诊断过程中的320个成人吸烟者的代表性样本随机入组到常规措施组与结合电话咨询和简报通讯的控烟干预组。分析吸烟量、一氧化碳水平、花费等结果。
结果：干预组和对照组都持续改善了3到12个月的效果评价。在12个月随访时使用意向-治疗分析评价两组间的自评报告和一氧化碳值差别均无统计学意义（吸烟量减少50%以上的比例分别为25% vs. 19%）。
结论：在缺乏尼古丁替代治疗的情况下，这种控烟措施的长期效果似乎不够显著。还需要进一步研究来提高干预效果、对项目变量进行更综合的分析。
（张永明编译 刘国梁审校）
Medical Care. 47(1):115-120, January 2009.
Long-Term Results of a Smoking Reduction Program.
Glasgow, Russell E. PhD *; Gaglio, Bridget MPH *; Estabrooks, Paul A. PhD *+; Marcus, Alfred C. PhD ++; Ritzwoller, Debra P. PhD *; Smith, Tammy L. BS ++; Levinson, Arnold H. PhD ++; Sukhanova, Anna MA *; O’Donnell, Colin MS ++; Ferro, Erica F. MA *; France, Eric K. MD *
From the *Kaiser Permanente, Denver, Colorado; +Virginia Polytechnic Institute and State University, Blacksburg, Virginia; and ++AMC Cancer Research Center, University of Colorado Denver Health Sciences Center, Denver, Colorado.
introduction: There have been few comprehensive evaluations of smoking reduction, especially in health care delivery systems, and little is known about its cost, maintenance of reduced smoking, or robustness across patient subgroups.
Methods: A generally representative sample of 320 adult smokers from an HMO scheduled for outpatient surgery or a diagnostic procedure was randomized to enhanced usual care or a theory-based smoking reduction intervention that combined telephone counseling and tailored newsletters. Outcomes included cigarettes smoked, carbon monoxide levels, and costs.
Results: Both intervention and control conditions continued to improve from 3- to 12-month assessments. Between-condition differences using intent-to-treat analyses on both self-report and carbon monoxide measures were nonsignificant by the 12-month follow-up (25% vs. 19% achieved 50% or greater reductions in cigarettes smoked). The intervention was implemented consistently despite logistical constraints and was generally robust across patient characteristics (eg, education, ethnicity, health literacy, dependence) .
Conclusions: In the absence of nicotine replacement therapy, the long-term effects of this smoking reduction intervention seem modest and nonsignificant. Future research is indicated to enhance intervention effects and conduct more comprehensive economic analyses of program variations.
DOI Number 10.1097/MLR.0b013e31817e18d1
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物质使用障碍治疗的退伍军人的戒烟心理干预评估
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在肺癌手术时实施戒烟计划的经济效益
