在患有勃起功能障碍的中国患者中的戒烟与依从性干预
2010/11/03
摘要
背景：吸烟与勃起功能障碍之间是否存在因果关系目前尚未确定。前期，没有在患有勃起功能障碍的吸烟者中进行过戒烟咨询和尼古丁替代治疗（NRT）依从性咨询方面的RCT试验。
目的：本试验旨在患有勃起功能障碍的中国吸烟者中研究戒烟咨询联合NRT是否能增加戒断和NRT的依从性，以及戒烟是否能改善勃起功能障碍。
设计：本试验为RCT。2004～2007年收集数据，2008年进行数据分析。
研究机构/参与者：参与者为719名患有勃起功能障碍的中国成人吸烟者，每天至少吸烟1支，在接下来的1周内有戒烟意向，同意采用NRT进行戒烟治疗。
干预：在基线状态、1周、3周时，A1组接受15分钟的戒烟咨询和3分钟的NRT依从性咨询，然后进行2周的免费NRT治疗。A2组除依从性咨询外，其他处理方式与A1组一致。B组接受10分钟的戒烟建议。在首次接触时，向所有受试者都发放了自助戒烟手册。
主要检测结果：研究6个月后检测受试者主诉的7天点戒断率、1个月时检测4周NRT依从性、6个月时检测勃起功能是否改善。
结果：干预组（A1+A2）获得较高比例的戒断率，自我主诉（23% vs 12.8%, RR=1.79, 95% CI=1.22, 2.62）和生化方法检测（11.4% vs 5.5%, RR=2.07, 95% CI=1.13, 3.77）的戒断率均较对照组高。A1与A2组之间在NRT依从性比例上无显著差异（13.7% vs 12.7%, RR=1.08, 95% CI=0.69, 1.69）。基线状态至6个月，勃起功能障碍得到改善，且与6个月时自我主诉的戒断相关，但与干预状态无关。
结论：虽然戒烟能改善勃起功能障碍，但是本研究的结果显示不同的戒烟手段，其戒烟转归也不同。
（林江涛 审校）
Am J Prev Med. 2010 Sep;39(3):251-258.
Smoking-Cessation and Adherence Intervention Among Chinese Patients with Erectile Dysfunction.
Chan SS, Leung DY, Abdullah AS, Lo SS, Yip AW, Kok WM, Ho SY, Lam TH.
Department of Nursing Studies, The University of Hong Kong, Hong Kong.
Abstract
BACKGROUND: Whether the association between smoking and erectile dysfunction is causal is uncertain. No RCTs have been previously conducted on cessation counseling and additional nicotine replacement therapy (NRT) adherence counseling among smokers with erectile dysfunction.
PURPOSE: The aim of the study was to determine if smoking-cessation counseling in conjunction with NRT increases quitting and NRT adherence compared to usual care, and if stopping smoking would improve erectile function among Chinese erectile dysfunction patients who smoke.
DESIGN: An RCT was conducted. Data were collected in 2004-2007 and analyzed in 2008.
SETTING/PARTICIPANTS: The sample included 719 Chinese adult erectile dysfunction patients who smoked at least 1 cigarette per day, intended to quit smoking within the next 7 days, and would use NRT.
INTERVENTIONS: Group A1 received 15-minute smoking-cessation and 3-minute NRT adherence counseling at baseline, 1 week, and 4 weeks with free NRT for 2 weeks. Group A2 received the same treatment, except for the adherence counseling. Group B received 10 minutes of quitting advice. All subjects received a self-help quitting booklet at first contact.
MAIN OUTCOME MEASURES: Self-reported 7-day tobacco abstinence at 6 months, 4-week NRT adherence at 1 month, and improvement in erectile dysfunction condition at 6 months.
RESULTS: The intervention groups (A1+A2) achieved higher rates of abstinence, both self-reported (23% vs 12.8%, RR=1.79, 95% CI=1.22, 2.62) and biochemically validated (11.4% vs 5.5%, RR=2.07, 95% CI=1.13, 3.77), than the control group. The NRT adherence rate did not differ between Groups A1 and A2 (13.7% vs 12.7%, RR=1.08, 95% CI=0.69, 1.69). An improvement in erectile dysfunction status from baseline to 6 months was associated with self-reported quitting at 6 months but not with intervention status.
CONCLUSIONS: Although quitting smoking was associated with improvement in erectile dysfunction, this study found significant outcome differences among the means used to achieve smoking cessation.
Am J Prev Med. 2010 Sep;39(3):251-258.
背景：吸烟与勃起功能障碍之间是否存在因果关系目前尚未确定。前期，没有在患有勃起功能障碍的吸烟者中进行过戒烟咨询和尼古丁替代治疗（NRT）依从性咨询方面的RCT试验。
目的：本试验旨在患有勃起功能障碍的中国吸烟者中研究戒烟咨询联合NRT是否能增加戒断和NRT的依从性，以及戒烟是否能改善勃起功能障碍。
设计：本试验为RCT。2004～2007年收集数据，2008年进行数据分析。
研究机构/参与者：参与者为719名患有勃起功能障碍的中国成人吸烟者，每天至少吸烟1支，在接下来的1周内有戒烟意向，同意采用NRT进行戒烟治疗。
干预：在基线状态、1周、3周时，A1组接受15分钟的戒烟咨询和3分钟的NRT依从性咨询，然后进行2周的免费NRT治疗。A2组除依从性咨询外，其他处理方式与A1组一致。B组接受10分钟的戒烟建议。在首次接触时，向所有受试者都发放了自助戒烟手册。
主要检测结果：研究6个月后检测受试者主诉的7天点戒断率、1个月时检测4周NRT依从性、6个月时检测勃起功能是否改善。
结果：干预组（A1+A2）获得较高比例的戒断率，自我主诉（23% vs 12.8%, RR=1.79, 95% CI=1.22, 2.62）和生化方法检测（11.4% vs 5.5%, RR=2.07, 95% CI=1.13, 3.77）的戒断率均较对照组高。A1与A2组之间在NRT依从性比例上无显著差异（13.7% vs 12.7%, RR=1.08, 95% CI=0.69, 1.69）。基线状态至6个月，勃起功能障碍得到改善，且与6个月时自我主诉的戒断相关，但与干预状态无关。
结论：虽然戒烟能改善勃起功能障碍，但是本研究的结果显示不同的戒烟手段，其戒烟转归也不同。
（林江涛 审校）
Am J Prev Med. 2010 Sep;39(3):251-258.
Smoking-Cessation and Adherence Intervention Among Chinese Patients with Erectile Dysfunction.
Chan SS, Leung DY, Abdullah AS, Lo SS, Yip AW, Kok WM, Ho SY, Lam TH.
Department of Nursing Studies, The University of Hong Kong, Hong Kong.
Abstract
BACKGROUND: Whether the association between smoking and erectile dysfunction is causal is uncertain. No RCTs have been previously conducted on cessation counseling and additional nicotine replacement therapy (NRT) adherence counseling among smokers with erectile dysfunction.
PURPOSE: The aim of the study was to determine if smoking-cessation counseling in conjunction with NRT increases quitting and NRT adherence compared to usual care, and if stopping smoking would improve erectile function among Chinese erectile dysfunction patients who smoke.
DESIGN: An RCT was conducted. Data were collected in 2004-2007 and analyzed in 2008.
SETTING/PARTICIPANTS: The sample included 719 Chinese adult erectile dysfunction patients who smoked at least 1 cigarette per day, intended to quit smoking within the next 7 days, and would use NRT.
INTERVENTIONS: Group A1 received 15-minute smoking-cessation and 3-minute NRT adherence counseling at baseline, 1 week, and 4 weeks with free NRT for 2 weeks. Group A2 received the same treatment, except for the adherence counseling. Group B received 10 minutes of quitting advice. All subjects received a self-help quitting booklet at first contact.
MAIN OUTCOME MEASURES: Self-reported 7-day tobacco abstinence at 6 months, 4-week NRT adherence at 1 month, and improvement in erectile dysfunction condition at 6 months.
RESULTS: The intervention groups (A1+A2) achieved higher rates of abstinence, both self-reported (23% vs 12.8%, RR=1.79, 95% CI=1.22, 2.62) and biochemically validated (11.4% vs 5.5%, RR=2.07, 95% CI=1.13, 3.77), than the control group. The NRT adherence rate did not differ between Groups A1 and A2 (13.7% vs 12.7%, RR=1.08, 95% CI=0.69, 1.69). An improvement in erectile dysfunction status from baseline to 6 months was associated with self-reported quitting at 6 months but not with intervention status.
CONCLUSIONS: Although quitting smoking was associated with improvement in erectile dysfunction, this study found significant outcome differences among the means used to achieve smoking cessation.
Am J Prev Med. 2010 Sep;39(3):251-258.
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戒烟的双目标概念
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联合经皮司来吉兰（selegiline）+认知行为治疗不能改善戒烟
