JAMA:持续咨询及戒烟药物对吸烟肿瘤患者戒烟率的影响

2020-10-14 MedSci原创 MedSci原创

对于新近确诊的吸烟肿瘤患者,持续的咨询和提供免费的戒烟药物有助于提高患者戒烟率。

长期吸烟可能会对肿瘤患者预后造成不良后果,近日研究人员比较了持续电话咨询和药物治疗(强化治疗)与短期电话咨询和药物咨询(标准治疗)对肿瘤患者戒烟率的影响。

这项非盲、随机临床试验在马萨诸塞州总医院/达纳法伯/哈佛癌症中心和斯隆-凯特林癌症中心进行。最近确诊的乳腺癌、胃肠癌、泌尿生殖道癌、妇科癌、头颈癌、肺癌、淋巴瘤癌或黑色素瘤癌患者参与,患者在近30天内有吸烟史,被随机分为强化治疗(n=153)和标准治疗(n=150)组。强化组接受4次双周和3次每月电话咨询,标准组接受4周的咨询,药物治疗手段包括尼古丁替代疗法、安非他酮或伐仑克林。研究的主要结果是在6个月的随访中,生物化学证实的7天烟草戒断率,次要结果是治疗利用率。

303名患者,平均年龄58.3岁,170名女性(56.1%),221名(78.1%)完成了试验。6个月生化证实的戒断率为强化治疗组34.5%(n=51),而标准治疗组为21.5%(n=29,差异为13.0%;优势比:1.92)。在强化治疗组中,完成的咨询的平均次数为8次。共有97名强化治疗参与者(77.0%)和68名标准治疗参与者(59.1%)报告停止使用药物治疗(差异:17.9%;优势比:2.31)。强化治疗组和标准治疗组最常见的不良事件分别为恶心(13 vs 6例)、皮疹(4 vs 1例)、打嗝(4 vs 1例)、口腔刺激(4 vs 0例)、睡眠困难(3 vs 2例)和异常梦境(3 vs 2例)。

研究认为,对于新近确诊的吸烟肿瘤患者,持续的咨询和提供免费的戒烟药物有助于提高患者戒烟率。

原始出处

Elyse R. Park et al. Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer A Randomized Clinical Trial.JAMA. October 13, 2020.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1424328, encodeId=c90a14243286e, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Fri Oct 16 10:08:32 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892215, encodeId=8e24892215dc, content=哈哈哈,强化疏导,有点儿类似洗脑...., beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Thu Oct 15 13:44:32 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892203, encodeId=d8a6892203b0, content=就是相当于反复强化呗<a href='/topic/show?id=fbc954130bb' target=_blank style='color:#2F92EE;'>#戒烟#</a>?考试前我也反复背题就为了多考几分🤪, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54130, encryptionId=fbc954130bb, topicName=戒烟)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Oct 15 11:12:39 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036305, encodeId=2412103630554, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Oct 14 22:08:32 CST 2020, time=2020-10-14, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1424328, encodeId=c90a14243286e, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Fri Oct 16 10:08:32 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892215, encodeId=8e24892215dc, content=哈哈哈,强化疏导,有点儿类似洗脑...., beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Thu Oct 15 13:44:32 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892203, encodeId=d8a6892203b0, content=就是相当于反复强化呗<a href='/topic/show?id=fbc954130bb' target=_blank style='color:#2F92EE;'>#戒烟#</a>?考试前我也反复背题就为了多考几分🤪, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54130, encryptionId=fbc954130bb, topicName=戒烟)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Oct 15 11:12:39 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036305, encodeId=2412103630554, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Oct 14 22:08:32 CST 2020, time=2020-10-14, status=1, ipAttribution=)]
    2020-10-15 rayms

    哈哈哈,强化疏导,有点儿类似洗脑....

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1424328, encodeId=c90a14243286e, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Fri Oct 16 10:08:32 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892215, encodeId=8e24892215dc, content=哈哈哈,强化疏导,有点儿类似洗脑...., beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Thu Oct 15 13:44:32 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892203, encodeId=d8a6892203b0, content=就是相当于反复强化呗<a href='/topic/show?id=fbc954130bb' target=_blank style='color:#2F92EE;'>#戒烟#</a>?考试前我也反复背题就为了多考几分🤪, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54130, encryptionId=fbc954130bb, topicName=戒烟)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Oct 15 11:12:39 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036305, encodeId=2412103630554, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Oct 14 22:08:32 CST 2020, time=2020-10-14, status=1, ipAttribution=)]
    2020-10-15 Psycho.Dr Du

    就是相当于反复强化呗#戒烟#?考试前我也反复背题就为了多考几分🤪

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1424328, encodeId=c90a14243286e, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Fri Oct 16 10:08:32 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892215, encodeId=8e24892215dc, content=哈哈哈,强化疏导,有点儿类似洗脑...., beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Thu Oct 15 13:44:32 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=892203, encodeId=d8a6892203b0, content=就是相当于反复强化呗<a href='/topic/show?id=fbc954130bb' target=_blank style='color:#2F92EE;'>#戒烟#</a>?考试前我也反复背题就为了多考几分🤪, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54130, encryptionId=fbc954130bb, topicName=戒烟)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Oct 15 11:12:39 CST 2020, time=2020-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036305, encodeId=2412103630554, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Oct 14 22:08:32 CST 2020, time=2020-10-14, status=1, ipAttribution=)]
    2020-10-14 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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