心理干预联合药物对吸烟者的戒烟效果评价

Effectiveness of Varenicline with counseling programs on smoking cessation in a targeted clinical setting in China

目的 评价伐尼克兰在临床实践中对戒烟门诊患者戒烟的有效性.方法 采用前瞻性观察性研究设计,选择符合纳入标准的吸烟者799人,每名患者首诊时进行标准的基线问卷评估,并在第1、第3和第6个月进行随访.由经过培训的医师对每名患者完成面对面的咨询和个体化戒烟干预.接受药物辅助戒烟者定为心理干预联合药物组（n=272）,未用药者为单纯心理干预组（n=527）.采用意向性分析的统计学方法分析比较两组的7天时点戒烟率、3个月随访时的1个月持续戒烟率和6个月随访时的3个月持续戒烟率.结果 6个月随访时,心理干预联合药物组的7天时点戒烟率显著高于单纯心理干预组（34.6％vs.23.1％;OR=1.75,95％ CI：1.27 ～ 2.42;P＜0.001）,心理干预联合药物组的3个月持续戒烟率也显著高于单纯心理干预组（31.3％vs.18.2％; OR=2.04,95％CI：1.46 ～ 2.86;P＜0.001）.1和3个月随访时,心理干预联合药物组无论是7天时点戒烟率还是1个月持续戒烟率均高于单纯心理干预组.结论 在真实临床实践的戒烟门诊中,给予戒烟者药物辅助戒烟可有效提高戒烟率.

Objective To evaluate the effectiveness of Varenicline for smoking cessation in a community-based smoking-cessation-clinic （SCC） in Chinese smokers.Methods A prospective observational study was conducted in Beijing,China.799 smokers （762 men and 37 women） were assessed on data gathered from structured questionnaires at baseline and follow up programs at 1,3 and 6 months.Trained physician counselors provided free individual counseling and follow-up interviews with brief counseling for all the subjects.272 subjects were additionally prescribed Varenicline according to their own choice and reported data were compared to those without Varenicline.Outcomes were self-reported,regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1,3 and 6 month follow-up periods.Results At 6-month and by intention-to-treat,the 7-day point prevalence on abstinence rate with Varenicline and counseling,was significantly higher than the group with counseling only （34.6％ versus 23.1％ ; OR=1.75,95％ CI：1.27-2.42; P＜0.001）.The 3-month continuous abstinence rate at 6 month was higher in the group with Varenicline （31.3％ versus 18.2％ ; OR=2.04,95％ CI：1.46-2.86; P＜0.001）.Varenicline also showed better outcomes at 1 and 3 month follow-up.Conclusion Varenicline prescription in the smoking cessation clinic appeared to be effective that doubled the rates of quitting among Chinese smokers in the practice at a community-based SCC.