公共场所禁烟能提高1年内安非他酮和戒烟咨询的戒烟效果
2009/11/17
前言：在许多欧洲国家，都发现立法禁烟有利于吸烟人数的下降。我们研究了意大利2005年室内禁烟令对单独咨询或与安非他酮联合戒烟咨询的戒烟效果。
方法：施行禁烟令前后（2001～2006），共计550名吸烟者参与罗马市的戒烟计划。吸烟者自己选择接受为期6周的单独咨询戒烟（GCT）或为期7周的戒烟咨询联合每日服用安非他酮戒烟。戒烟后12，26及52周对其进行随访。由于本试验为观察性研究，我们采用倾向性评分来匹配安非他酮组和GCT单独戒烟组参与者，人数分别为138名和290名（禁烟令前/后）。
结果：除了GCT单独戒烟组的“咖啡因使用”人群，两个匹配样本人群的其它变量均未见显著性差异。回归校正的OR显示，禁烟令施行第12个月时，联合治疗组的持续吸烟OR下降了52％，GCT单独戒烟组的持续吸烟OR下降了41％。结果显示，禁烟令与12个月的戒断率和戒断动机增加相关。媒介分析显示，在对戒烟动机控制后，禁烟令对戒断率的作用下降，说明戒烟动机为戒烟的部分媒介。
讨论：施行室内禁烟令能改善戒烟治疗的效果，这可能与戒烟动机水平升高有关。
（刘国梁 审校）
Nicotine Tob Res. 2009 Sep;11(9):1114-1121.
A smoking ban in public places increases the efficacy of bupropion and counseling on cessation outcomes at 1 year.
Grassi MC, Enea D, Ferketich AK, Lu B, Nencini P.
INTRODUCTION: Legal restrictions have contributed to the decline in smoking prevalence in several European countries. We investigated the impact of the Italian 2005 indoor smoking ban on the efficacy of counseling alone or in combination with bupropion for smoking cessation.
METHODS: Before and after the introduction of the ban (2001-2006), 550 smokers were enrolled in the smoking cessation program in Rome and were asked to choose between a 6-week group counseling therapy (GCT) given alone or in combination with 7 weeks of daily bupropion. Follow-up was completed 12, 26, and 52 weeks after the quit day. Due to the observational nature of the study, we used propensity scores to match 138 and 290 subjects (pre-/postban) in the bupropion- and GCT-only groups, respectively.
RESULTS: Covariate balance in the two matched samples was adequate for all variables except "coffee consumption" in the GCT-only group. The regression adjusted odds ratios indicated that the introduction of the ban resulted in 52% reduced odds of continued smoking at 12 months among the GCT + bupropion group and 41% reduced odds in the GCT-only group. We observed that the ban was associated with both increased 12-month abstinence rates and motivation to quit. In a mediation analysis, we determined that the total effect of the smoking ban on the abstinence rate was reduced after controlling for motivation, which confirmed that motivation was a partial mediator.
DISCUSSION: The introduction of an indoor smoking ban improved the efficacy of smoking cessation treatments by possibly providing a setting that increased the level of motivation to stop smoking.
Grassi MC, et al. Nicotine Tob Res. 2009 Sep;11(9):1114-21.
方法：施行禁烟令前后（2001～2006），共计550名吸烟者参与罗马市的戒烟计划。吸烟者自己选择接受为期6周的单独咨询戒烟（GCT）或为期7周的戒烟咨询联合每日服用安非他酮戒烟。戒烟后12，26及52周对其进行随访。由于本试验为观察性研究，我们采用倾向性评分来匹配安非他酮组和GCT单独戒烟组参与者，人数分别为138名和290名（禁烟令前/后）。
结果：除了GCT单独戒烟组的“咖啡因使用”人群，两个匹配样本人群的其它变量均未见显著性差异。回归校正的OR显示，禁烟令施行第12个月时，联合治疗组的持续吸烟OR下降了52％，GCT单独戒烟组的持续吸烟OR下降了41％。结果显示，禁烟令与12个月的戒断率和戒断动机增加相关。媒介分析显示，在对戒烟动机控制后，禁烟令对戒断率的作用下降，说明戒烟动机为戒烟的部分媒介。
讨论：施行室内禁烟令能改善戒烟治疗的效果，这可能与戒烟动机水平升高有关。
（刘国梁 审校）
Nicotine Tob Res. 2009 Sep;11(9):1114-1121.
A smoking ban in public places increases the efficacy of bupropion and counseling on cessation outcomes at 1 year.
Grassi MC, Enea D, Ferketich AK, Lu B, Nencini P.
INTRODUCTION: Legal restrictions have contributed to the decline in smoking prevalence in several European countries. We investigated the impact of the Italian 2005 indoor smoking ban on the efficacy of counseling alone or in combination with bupropion for smoking cessation.
METHODS: Before and after the introduction of the ban (2001-2006), 550 smokers were enrolled in the smoking cessation program in Rome and were asked to choose between a 6-week group counseling therapy (GCT) given alone or in combination with 7 weeks of daily bupropion. Follow-up was completed 12, 26, and 52 weeks after the quit day. Due to the observational nature of the study, we used propensity scores to match 138 and 290 subjects (pre-/postban) in the bupropion- and GCT-only groups, respectively.
RESULTS: Covariate balance in the two matched samples was adequate for all variables except "coffee consumption" in the GCT-only group. The regression adjusted odds ratios indicated that the introduction of the ban resulted in 52% reduced odds of continued smoking at 12 months among the GCT + bupropion group and 41% reduced odds in the GCT-only group. We observed that the ban was associated with both increased 12-month abstinence rates and motivation to quit. In a mediation analysis, we determined that the total effect of the smoking ban on the abstinence rate was reduced after controlling for motivation, which confirmed that motivation was a partial mediator.
DISCUSSION: The introduction of an indoor smoking ban improved the efficacy of smoking cessation treatments by possibly providing a setting that increased the level of motivation to stop smoking.
Grassi MC, et al. Nicotine Tob Res. 2009 Sep;11(9):1114-21.
