将戒烟治疗作为抑郁和焦虑的常规心理护理的一部分（ESCAPE）：一项随机对照、多中心、可接受性和可行性的嵌套定性方法试验。

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-03-11 DOI:10.1111/add.16718

Gemma M. J. Taylor, Katherine Sawyer, Pamela Jacobsen, Tom P. Freeman, Anna Blackwell, Shadi Daryan, Chris Metcalfe, David Kessler, Marcus R. Munafò, Paul Aveyard

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引用次数: 0

摘要

背景和目的：有证据表明戒烟可以改善抑郁和焦虑症状。我们评估了在提供认知行为疗法（CBT）治疗常见精神疾病的服务中实施和试验戒烟干预的可行性。设计、环境和参与者：本研究是一项务实、双臂、随机、多中心、可接受性和可行性的联合设计戒烟干预（ISRCTN99531779）试验，涉及英国国民健康服务（NHS）资助的四个NHS信托基金治疗抑郁症或焦虑症的服务。参与者包括因抑郁或焦虑而开始CBT的成年每日吸烟者[平均年龄35.6岁，标准差(SD) = 12.7, 89.6%白人]，吸烟14.3 （SD = 8.2）支/天，平均广泛性焦虑障碍问卷-7 （GAD-7）和患者健康问卷-9 （PHQ-9）得分分别为13.1 （SD = 4.9）和14.5 （SD = 6.0）。68名参与者被分配到治疗组，67名参与者被分配到对照组。干预与控制：两组均接受CBT治疗抑郁或焦虑。治疗组还接受了多达12次的综合戒烟支持。对照组在治疗后接受戒烟服务。测量：随访时间为3个月和6个月。主要结果是3个月的“研究完成”。其他结果包括可接受性、满意度、可行性、数据完整性和心理健康。结果：3个月时，治疗不影响研究完成[优势比(OR) = 0.81, 95%可信区间(CI) = 0.31 ~ 2.09]，不损害心理健康（PHQ-9差异系数0.01,95% CI = -2.19 ~ 2.22）；GAD-7：系数0.65,95% CI = -1.59 ~ 2.90)，但增加了戒断率（OR = 8.69, 95% CI = 1.11 ~ 396.26）。招募是可以接受的，关键利益相关者对干预感到满意。结论：在接受CBT治疗抑郁或焦虑的英国成年吸烟者中，CBT治疗中的戒烟干预得到了很好的接受，没有干扰主要治疗目标，并且增加了戒烟。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

intEgrating Smoking Cessation treatment As part of usual Psychological care for dEpression and anxiety (ESCAPE): A randomised and controlled, multi-centre, acceptability and feasibility trial with nested qualitative methods

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Background and aim

There is evidence that smoking cessation may improve depression and anxiety symptoms. We assessed the feasibility of implementing and trialling a smoking cessation intervention in services providing cognitive behavioural therapy (CBT) for common mental illness.

Design, setting and participants

This study was a pragmatic, two-armed, randomised, multi-centre, acceptability and feasibility trial of a co-designed smoking cessation intervention (ISRCTN99531779) involving United Kingdom National Health Service (NHS)-funded services treating depression or anxiety among four NHS Trusts. Participants comprised adult daily smokers starting CBT for depression or anxiety [mean age 35.6 years, standard deviation (SD) = 12.7, 89.6% white] who smoked 14.3 (SD = 8.2) cigarettes/day with mean Generalised Anxiety Disorder Questionnaire-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores of 13.1 (SD = 4.9) and 14.5 (SD = 6.0). Sixty-eight participants were allocated to the treatment group and 67 to control.

Intervention and control

Both groups received CBT for depression or anxiety. The treatment group also received up to 12 sessions of integrated smoking cessation support. The control group was signposted to smoking cessation services post-treatment.

Measurements

Follow-up was at 3 and 6 months. The primary outcome was ‘study completion’ by 3 months. Other outcomes included acceptability, satisfaction, feasibility, data completeness and mental health.

Findings

At 3 months, treatment did not affect study completion [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.31 to 2.09], did not harm mental health (PHQ-9 difference: coefficient 0.01, 95% CI = −2.19 to 2.22); GAD-7: coefficient 0.65, 95% CI = −1.59 to 2.90), but increased abstinence rates (OR = 8.69, 95% CI = 1.11 to 396.26). Recruitment was acceptable and key stakeholders were satisfied with the intervention.

Conclusions

Among UK adult smokers receiving CBT treatment for depression or anxiety, a smoking cessation intervention within the CBT treatment was well received, did not interfere with the primary treatment goals and increased smoking cessation.

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.