尼古丁替代疗法和行为干预在戒烟中的有效性——一项三级医院随机对照试验

IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Utkal Keshari Mohanty, Kuldeep Kumar, Gaurav Sharma, Swapna Sarit, Hemamalini Rath
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引用次数: 0

摘要

在印度,尼古丁替代疗法(NRT)对无烟烟草(SLT)使用者的有效性尚未得到充分探索,之前的研究主要集中在吸烟者身上。本研究评估并比较了联合行为干预(BI)和NRT与单独BI对戒烟和SLT的有效性。方法:这项为期1.5年的前瞻性、开放标签、三组平行随机对照试验在印度奥里萨邦SCB牙科学院和医院戒烟诊所进行。三个干预组——BI、BI+尼古丁贴片和BI+尼古丁口香糖——使用预先验证的社会人口统计、相关医疗和牙科史、口腔卫生习惯和以前的烟草使用模式进行评估。结果:该研究招募了130名参与者。在26周时,63.3%(19/30)的BI+贴片组和52.9%(18/34)的BI+口香糖组实现了戒断,而BI组为24.1%(7/29)。比值比(OR), 95%置信区间(CI);戒断的p值为6.03 (1.90 ~ 19.15);BI + patch p=0.003), p= 3.25 (1.08 ~ 9.78;p=0.035)。在SLT使用者中,有70.59%(12/17)的人使用BI+贴片实现了戒断(OR 6.40, 95% CI: 1.57-26.03;p =0.010)和53.85% (14/26)BI+gum (OR 3.11, 95% CI: 0.92-10.47;p=0.067),而单纯BI组为27.27%(6/22)。两个干预组均显示,与单纯BI相比,复发风险显著降低(风险比[HR] 0.45, 95% CI: 0.24-0.83;p=0.011),危险度0.40,95% CI: 0.22-0.74;BI+gum p=0.003。结论:BI+NRT联合治疗比单纯BI治疗更有效。BI+贴片联合使用比BI+口香糖和单独使用BI更有效。与标准BI组相比,NRT干预组有更高的戒断率和更少的复发。需要进一步的研究来验证这些发现。意义:本研究描述了结合行为干预(BI)和尼古丁替代疗法(NRT)在促进无烟烟草(SLT)使用者戒烟和降低复发率方面的有效性。研究结果强调了BI+NRT比单独BI的优越性,因为与BI组相比,BI+贴片组和BI+口香糖组表现出显著的疗效、更高的戒断几率和更低的复发率。该研究强调了将NRT纳入戒烟计划的重要性,通过强调需要综合方法和量身定制的干预措施来解决成瘾挑战,重点是SLT使用者,从而提高长期效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of Nicotine Replacement Therapy and Behavioral Intervention in Tobacco Cessation-A Tertiary Hospital-Based Randomized Controlled Trial.

Introduction: The effectiveness of nicotine replacement therapy (NRT) on smokeless tobacco (SLT) users is underexplored in India, with prior research primarily focusing on smokers. This study assessed and compared the effectiveness of combining behavioral intervention (BI) and NRT with BI alone on smoking and SLT cessation.

Methods: This 1.5-year prospective, open-label, three-arm parallel-group randomized controlled trial was conducted at the Tobacco Cessation Clinic, SCB Dental College and Hospital, Odisha, India. The three intervention groups-BI, BI+nicotine patch, and BI+nicotine gum-were assessed using a prevalidated proforma on sociodemographics, relevant medical and dental history, oral hygiene practices, and previous tobacco use patterns.

Results: The study enrolled 130 participants. At 26 weeks, 63.3% (19/30) in the BI+patch and 52.9% (18/34) in the BI+gum achieved abstinence, compared to 24.1% (7/29) in the BI group. The odds ratio (OR), 95% confidence interval (CI); p-value of abstinence was 6.03 (1.90-19.15; p=0.003) for BI + patch, and 3.25 (1.08-9.78; p=0.035) for BI+gum. Among SLT users, abstinence was achieved in 70.59% (12/17) with BI+patch (OR 6.40, 95% CI: 1.57-26.03; p =0.010) and 53.85% (14/26) with BI+gum (OR 3.11, 95% CI: 0.92-10.47; p=0.067) versus 27.27% (6/22) with BI alone. Both intervention groups demonstrated significantly reduced relapse risk versus BI alone (Hazard ratio [HR] 0.45, 95% CI: 0.24-0.83; p=0.011) for BI+patch and HR 0.40, 95% CI: 0.22-0.74; p=0.003 for BI+gum.

Conclusion: Combination therapy (BI+NRT) is more effective than BI alone. The BI+patch combination is more effective than BI+gum and BI alone. The NRT intervention groups had higher abstinence rates and reduced relapses than the standard BI group. Further studies are required to validate these findings.

Implications: This study portrays the effectiveness of combining behavioral intervention (BI) with nicotine replacement therapy (NRT) in promoting cessation of tobacco use in smokeless tobacco (SLT) users and reducing relapse rates. The findings highlight the superiority of BI+NRT over BI alone as they demonstrate notable efficacy, higher odds of abstinence, and lower relapse rates in the BI+patch and BI+gum group as compared to the BI group. The study underscores the significance of integrating NRT into cessation programs to enhance long-term outcomes by emphasizing the need for comprehensive approaches and tailored interventions to address the challenges of addiction with a focus on SLT users.

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来源期刊
Nicotine & Tobacco Research
Nicotine & Tobacco Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
10.60%
发文量
268
审稿时长
3-8 weeks
期刊介绍: Nicotine & Tobacco Research is one of the world''s few peer-reviewed journals devoted exclusively to the study of nicotine and tobacco. It aims to provide a forum for empirical findings, critical reviews, and conceptual papers on the many aspects of nicotine and tobacco, including research from the biobehavioral, neurobiological, molecular biologic, epidemiological, prevention, and treatment arenas. Along with manuscripts from each of the areas mentioned above, the editors encourage submissions that are integrative in nature and that cross traditional disciplinary boundaries. The journal is sponsored by the Society for Research on Nicotine and Tobacco (SRNT). It publishes twelve times a year.
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