基于家庭的行为干预对低收入家庭戒烟的有效性:系统回顾和荟萃分析。

IF 10 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
EClinicalMedicine Pub Date : 2025-08-11 eCollection Date: 2025-09-01 DOI:10.1016/j.eclinm.2025.103420
Meng Yao Li, Tzu Tsun Luk, Derek Yee Tak Cheung, Zi Qiu Guo, Ka Ka Siu, Jia Guo, Sophia Siu Chee Chan, Tai Hing Lam, Sai Yin Ho, Sheng Zhi Zhao, Man Ping Wang
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引用次数: 0

摘要

背景:吸烟对低收入家庭的危害很大。以家庭为基础的行为干预对这一人群的戒烟效果仍不确定。本综述旨在评估以家庭为基础的行为干预对低收入家庭戒烟的有效性。方法:本系统综述和荟萃分析通过检索6个数据库和1个临床试验注册中心,检索从成立到2024年1月30日发表的研究(更新检索至2025年1月1日)。纳入了针对低收入家庭吸烟父母、年龄≤18岁儿童共同生活的家庭行为干预的随机对照试验。数据提取和分析由两名研究者按照系统评价和荟萃分析指南的首选报告项目独立进行。主要结果是自我报告的7天点流行戒断(PPA)或3个月或更长时间的生化验证戒断。采用随机效应模型,采用Mantel-Haenszel法计算相对危险度(RR)。该研究已在PROSPERO注册(CRD42023466096)。结果:纳入综述的22项试验(N = 5292)中,有12项(N = 2782)纳入meta分析。大多数试验(17/22)为中等或高质量。与常规护理相比,以家庭为基础的行为干预在随访3个月或更长时间后显著增加了自我报告的7天PPA (RR:1.70, 95%CI: 1.16-2.48)。行为咨询联合尼古丁替代疗法(NRT)最有效(RR: 2.45, 95% CI: 1.28-4.68), 12个月随访(RR: 1.96, 95% CI: 1.44-2.66)。在非哮喘儿童的父母(RR: 1.88, 95% CI: 1.39-2.53)、父母均吸烟(RR: 1.79, 95% CI: 1.23-2.60)和包括NRT提供的干预措施(RR: 1.78, 95% CI: 1.15-2.74)中观察到进一步的显著影响。解释:以家庭为基础的行为干预显著增加了父母双方吸烟并包括药物治疗的低收入家庭的戒断。将行为咨询与NRT相结合并实施长期随访的干预措施往往更有效。资金:没有。
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 family-based behavioral intervention for smoking cessation in low-income households: a systematic review and meta-analysis.

Background: Smoking-attributable harms are substantial in low-income households. The effectiveness of family-based behavioral interventions for smoking cessation in this population remains uncertain. This review aims to assess the effectiveness of family-based behavioral interventions on smoking cessation in low-income households.

Methods: This systematic review and meta-analysis were conducted by searching six databases and one clinical trial registry for studies published from inception to 30 January 2024 (with an updated search conducted until 1st January 2025). Randomized controlled trials of family-based behavioral interventions for smoking parents from low-income households, co-living children aged ≤18 years, were included. Data extraction and analysis were independently performed by two investigators following the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Primary outcomes were self-reported 7-day point prevalence abstinence (PPA) or biochemically validated abstinence at 3 months or longer. The Mantel-Haenszel method was used to calculate the relative risk (RR) with random-effect model. The study was registered on PROSPERO (CRD42023466096).

Findings: Among 22 trials (N = 5292) included in the review, 12 (N = 2782) were analyzed in the meta-analysis. Most of trials (17/22) were of moderate or high quality. Family-based behavioral interventions significantly increased self-reported 7-day PPA (RR:1.70, 95%CI: 1.16-2.48) compared with usual care at follow-ups of 3 months or longer. Behavioral counseling combined with nicotine replacement therapy (NRT) was most effective (RR: 2.45, 95% CI: 1.28-4.68) and for 12-month follow-up (RR: 1.96, 95% CI: 1.44-2.66). Further significant effects were observed in parents of non-asthmatic children (RR: 1.88, 95% CI: 1.39-2.53), parents both smoked (RR: 1.79, 95% CI: 1.23-2.60), and interventions including NRT provision (RR: 1.78, 95% CI: 1.15-2.74).

Interpretation: Family-based behavioral interventions significantly increased abstinence in low-income households where both parents smoked and pharmacotherapy was included. Interventions that incorporated behavioral counseling with NRT and implemented with a long-term follow-up tended to be more effective.

Funding: None.

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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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