哮喘联盟

   摘要
   背景：数百万的美国人因进入无烟监狱而被迫戒烟，但是大多数人会复吸。为了使监狱释放人员持续戒烟，干预措施是必要的。
   目的：基于动机性访谈（MI）和认知行为疗法来评价室内吸烟消除（WISE）干预措施减少复吸的程度。
   研究设计：受试者是来自美国无烟监狱约8周前被释放的人，随机进行6次每周视频教育（对照组）或WISE干预。
   机构：美国一所无烟监狱。
   受试者：共纳入262例（35%女性）。
   主要结果评价：通过检测尿可替宁来确定持续戒烟率，定义为戒烟7天时点患病率。
   结果：经过3周随访， WISE干预组有25%(31/122)的受试者、对照组有7% (9/125)的受试者实现了持续戒烟 (优势比OR=4.4; 95% CI, 2.0-9.7)。除干预措施外，西班牙种族、坚持戒烟计划、被关押超过6个月都与提高坚持戒烟概率相关。Logistic回归分析，随访3周后随机分配到WISE干预组受试者的坚持戒烟率约为对照组的6.6倍。对随访3周后的非吸烟者在其出狱后再继续随访3个月，采用尿液可替宁测定结果证实，WISE干预组有12%(14 /122)的受试者、对照组有2%(3/125)的受试者在随访的3个月里没有吸烟(优势比OR= 5.3; 95% CI, 1.4-23.8)。
   结论：单凭监狱服刑期间的被迫戒烟对于释放后的吸烟情况影响很小。释放前进行行为干预可以极大改善出狱人员在社区中的持续戒烟率。  

 

 (林江涛 审校)
JAMA Intern Med. 2013 Apr 8:1-6. doi: 10.1001/jamainternmed.2013.197. [Epub ahead of print]

 

Forced Smoking Abstinence: Not Enough for Smoking Cessation.
 

Clarke JG, Stein LA, Martin RA, Martin SA, Parker D, Lopes CE, McGovern AR, Simon R, Roberts M, Friedman P, Bock B.
 

Abstract
IMPORTANCE：Millions of Americans are forced to quit smoking as they enter tobacco-free prisons and jails, but most return to smoking within days of release. Interventions are needed to sustain tobacco abstinence after release from incarceration.
OBJECTIVE：To evaluate the extent to which the
WISE：intervention (Working Inside for Smoking Elimination), based on motivational interviewing (MI) and cognitive behavioral therapy (CBT), decreases relapse to smoking after release from a smoke-free prison.
DESIGN：Participants were recruited approximately 8 weeks prior to their release from a smoke-free prison and randomized to 6 weekly sessions of either education videos (control) or the WISE intervention. SETTING A tobacco-free prison in the United States.
PARTICIPANTS：A total of 262 inmates (35% female).
MAIN OUTCOME MEASURE：Continued smoking abstinence was defined as 7-day point-prevalence abstinence validated by urine cotinine measurement.
RESULTS：At the 3-week follow-up, 25% of participants in the WISE intervention (31 of 122) and 7% of the control participants (9 of 125) continued to be tobacco abstinent (odds ratio [OR], 4.4; 95% CI, 2.0-9.7). In addition to the intervention, Hispanic ethnicity, a plan to remain abstinent, and being incarcerated for more than 6 months were all associated with increased likelihood of remaining abstinent. In the logistic regression analysis, participants randomized to the WISE intervention were 6.6 times more likely to remain tobacco abstinent at the 3-week follow up than those randomized to the control condition (95% CI, 2.5-17.0). Nonsmokers at the 3-week follow-up had an additional follow-up 3 months after release, and overall 12% of the participants in the WISE intervention (14 of 122) and 2% of the control participants (3 of 125) were tobacco free at 3 months, as confirmed by urine cotinine measurement (OR, 5.3; 95% CI, 1.4-23.8).
CONCLUSIONS AND RELEVANCE：Forced tobacco abstinence alone during incarceration has little impact on postrelease smoking status. A behavioral intervention provided prior to release greatly improves cotinine-confirmed smoking cessation in the community.

JAMA Intern Med. 2013 Apr 8:1-6. doi: 10.1001/jamainternmed.2013.197. [Epub ahead of print]