Enhancing partner support to improve smoking cessation

  • Review
  • Intervention

Authors


Abstract

Background

While many cessation programmes are available to assist smokers in quitting, research suggests that partner involvement may encourage long-term abstinence.

Objectives

The purpose of this review was to determine if an intervention to enhance partner support helps smoking cessation when added as an adjunct to a smoking cessation programme.

Search methods

The search was performed in: Cochrane Tobacco Addiction Group specialized register (Oct 2007), Cochrane controlled trials register (Oct 2007), (1966-Oct 2007), MEDLINE (1966-Oct 2007), EMBASE (1974-Oct 2007), PsycINFO (1861-Oct 2007). The search terms used were smoking (prevention, control, therapy), smoking cessation, and support (family, marriage, spouse, partner, sexual partner, buddy, friend, co-habitees, and co-worker).

Selection criteria

Randomized controlled trials of smoking cessation interventions that compared an intervention that included a partner support component with an otherwise identical intervention and reported follow up of six months or longer.

Data collection and analysis

Two authors independently identified the included studies and extracted data using a structured form. A third author was consulted to aid in the resolution of discrepancies. Abstinence, biochemically validated if possible, was the primary outcome measure and was extracted at two post-treatment intervals: 6-9 months and >12 months. The scores of PIQ (partner interaction questionnaire) were also analyzed to assess partner support. A fixed-effect model was used to pool relative risks from each study and estimate a summary effect .

Main results

A total of 49 articles were identified for this review. Only ten articles (11 studies, >2000 participants) met the inclusion criteria. The definition of partner varied between studies. All studies gave self-reported smoking cessation rates, but there was limited biochemical validation of abstinence. The risk ratio for self-reported abstinence at 6-9 months was 1.01 (95% CI, 0.86 to 1.18); and at 12 months post-treatment was 1.04 (95% CI, 0.87 to 1.24). Of the six studies that measured partner support at follow up, only two studies reported significant increase in partner support in the intervention groups.

Authors' conclusions

In this review of randomized controlled trials of interventions designed to enhance partner support for smokers in cessation programmes, we failed to detect an increase in quit rates. Limited data from several of the trials suggest that these interventions did not increase partner support either. No conclusions can be made about the impact of partner support on smoking cessation. More systematic intervention to affect partnership significantly should be delivered if partner support were part of an existing cessation programme.

摘要

背景

強化同伴支持來增加戒菸

儘管有許多的戒菸計畫來協助吸菸者戒菸,但是研究建議有同伴一起參與戒菸更有助於長期的戒菸。

目標

本篇文獻的目的是決定是否能在研究的處置中增加強調同伴的支持來協助戒菸,而強化同伴支持協助戒菸是一個輔助戒菸計劃的一部分。

搜尋策略

搜尋Cochrane Tobacco Addiction Group specialized register (Apr 2004), Cochrane controlled trials register (Apr 2004), CDC and PreventionTobacco Information and Prevention Database (Jul 2000), MEDLINE (1966Apr 2004), Cancer Lit (1966Apr 2004), EMBASE (1974Apr 2004), CINAHL (1966Jul 2000), PsycInfo (1861Apr 2004), ERIC, PsycLit, & Dissertation Abstracts (1861Dec 1999), SSCI (1972Apr 2004) and HealthStar (1975Jul 2000). 搜尋的詞彙包括吸菸(預防、控制、治療)、戒菸和支持(家庭、婚姻、配偶、同伴、性伴侶、哥們、朋友、共同嗜好者、同事)。搜尋的語言限於英語發表的研究。

選擇標準

有關戒菸處遇的隨機試驗的研究,比較一個包括有同伴支持成份的處遇和其他相同的處遇,並追蹤 6個月或更久。

資料收集與分析

兩名作者分別使用結構化的表格來確認出納入的研究和摘錄資料。當意見相佐時,第三位作者協助解決差異。禁菸和生化評估是主要結果,並在處遇後的兩個時間點進行分析:6 – 9 月和 >12 月。以PIQ分數(合作夥伴交互問卷)進行了分析,來評估合作夥伴的支持。使用固定效應模式來評估研究的整體影響。

主要結論

本篇文獻確認出40篇文章。只有8篇文章(9篇研究)符合納入標準。在這些文章中對於同伴的定義都不同。所有研究都包含自我報告的戒菸率的資料,而對戒菸率的生化驗證的資料是有限的。在6 – 9個月的自我報告戒菸的勝算比1.08 (CI 95%, 0.81 −1.44); 和在治療後12個月的勝算比是1.0 (CI 95%, 0.75  1.34). 其中測量同伴支持的6篇研究中,只有2篇的研究反應出在治療組中同伴支持能顯著的增加戒菸。

作者結論

在本文中,採用對吸菸者的戒菸計劃中設計來提高合作夥伴支持的隨機對照試驗,我們沒有檢測到有提高戒菸率。來自幾個研究的有限的數據顯示,這些處遇也同樣沒有增加任何同伴間的支持。對於同伴的支持能增加戒菸的影響力也無法有任何的結論。如果夥伴的支持是現有戒菸計劃的一部份,那麼能顯著的影響夥伴關係的多種系統性的處遇則需多被施行。

翻譯人

本摘要由彰化基督教醫院胡淑惠翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

由同伴或其他人支持吸菸者戒菸,並幫助吸菸者得到改善的處遇尚未被證實可以改善長期戒菸率。獲得夥伴和其他人的支持,這樣的吸菸者比較容易成功的戒菸。 和戒菸方案中並沒有一個同伴支持的處遇相比,在處遇中意圖提高所得到同伴的支持的戒菸方案並沒有證明能增加長期的戒菸率。而處遇可能沒有成功地改變所提供的支持。

Plain language summary

Are there ways to help partners and others to give more effective support to people who are trying to quit smoking

Smokers who get support from partners and other people are more likely to quit. Interventions intended to improve the support received have not been shown to increase long-term quit rates compared to a smoking cessation programme without a partner support component. The interventions may not have successfully changed the support provided.

Ancillary