How soon should alternative smoking cessation treatments be offered after incomplete response to nicotine replacement therapy?

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-08-08 DOI:10.1016/j.drugalcdep.2025.112823

Scott Veldhuizen , Saron Yohannes , Victor Tang , Peter Selby , Laurie Zawertailo

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Abstract

Background

Several effective interventions exist for tobacco dependence. These operate via different mechanisms, making treatment sequencing an important clinical option. As total time in treatment is often short, determining the length of each trial is crucial. In this analysis, we examine how cessation probability varies with time in treatment in a large program providing nicotine replacement therapy (NRT).

Methods

We used data on 87,952 people enrolled in the Smoking Treatment for Ontario Patients (STOP) program between 2014 and 2024. We fit a log-logistic interval-censored survival model to examine cessation probability as a function of time in treatment. We adjusted for sociodemographic and clinical variables and included willingness to set a quit date as an ancillary parameter. We used multiple imputation to include cases with missing baseline variables.

Results

The predicted probability of cessation was 15.5 % for the first week, 9.4 % for the second, and decreased to 3 % per week by 12 weeks. People who had set a quit date were markedly more likely to quit soon after initiation, but the general pattern of decreasing probability of full response was present for all participants.

Conclusion

People receiving NRT are most likely to quit very early in their course of treatment, and become unlikely to do so after several weeks without full response. Given the limited length of most courses of care, this implies that an offer of alternative interventions, if available, might best be made after a relatively short trial of NRT.

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在对尼古丁替代疗法反应不完全后，应该多快提供替代戒烟治疗？

背景：针对烟草依赖存在一些有效的干预措施。它们通过不同的机制起作用，使治疗测序成为重要的临床选择。由于治疗的总时间通常很短，因此确定每次试验的长度至关重要。在本分析中，我们研究了在提供尼古丁替代疗法（NRT）的大型项目中，戒烟概率如何随治疗时间变化。方法：我们使用了2014年至2024年间参加安大略省患者吸烟治疗（STOP）项目的87,952人的数据。我们拟合了一个逻辑间隔审查生存模型来检验戒烟概率作为治疗时间的函数。我们调整了社会人口学和临床变量，并将设定戒烟日期的意愿作为辅助参数。我们使用多重输入来包括缺少基线变量的情况。结果第1周预测戒烟率为15.5%，第2周预测戒烟率为9.4%，第12周预测戒烟率为3%。设定了戒烟日期的人明显更有可能在开始戒烟后不久就戒烟，但所有参与者都表现出全面反应概率下降的一般模式。结论接受NRT治疗的患者很可能在治疗早期就退出，而在几周后没有完全缓解就不太可能退出。鉴于大多数治疗疗程的长度有限，这意味着如果有其他干预措施，最好在相对较短的NRT试验后提供。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.