目的 评价伐尼克兰在临床实践中对戒烟门诊患者戒烟的有效性.方法 采用前瞻性观察性研究设计,选择符合纳入标准的吸烟者799人,每名患者首诊时进行标准的基线问卷评估,并在第1、第3和第6个月进行随访.由经过培训的医师对每名患者完成面对面的咨询和个体化戒烟干预.接受药物辅助戒烟者定为心理干预联合药物组(n=272),未用药者为单纯心理干预组(n=527).采用意向性分析的统计学方法分析比较两组的7天时点戒烟率、3个月随访时的1个月持续戒烟率和6个月随访时的3个月持续戒烟率.结果 6个月随访时,心理干预联合药物组的7天时点戒烟率显著高于单纯心理干预组(34.6%vs.23.1%;OR=1.75,95% CI:1.27 ~ 2.42;P<0.001),心理干预联合药物组的3个月持续戒烟率也显著高于单纯心理干预组(31.3%vs.18.2%; OR=2.04,95%CI:1.46 ~ 2.86;P<0.001).1和3个月随访时,心理干预联合药物组无论是7天时点戒烟率还是1个月持续戒烟率均高于单纯心理干预组.结论 在真实临床实践的戒烟门诊中,给予戒烟者药物辅助戒烟可有效提高戒烟率.
Objective To evaluate the effectiveness of Varenicline for smoking cessation in a community-based smoking-cessation-clinic (SCC) in Chinese smokers.Methods A prospective observational study was conducted in Beijing,China.799 smokers (762 men and 37 women) were assessed on data gathered from structured questionnaires at baseline and follow up programs at 1,3 and 6 months.Trained physician counselors provided free individual counseling and follow-up interviews with brief counseling for all the subjects.272 subjects were additionally prescribed Varenicline according to their own choice and reported data were compared to those without Varenicline.Outcomes were self-reported,regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1,3 and 6 month follow-up periods.Results At 6-month and by intention-to-treat,the 7-day point prevalence on abstinence rate with Varenicline and counseling,was significantly higher than the group with counseling only (34.6% versus 23.1% ; OR=1.75,95% CI:1.27-2.42; P<0.001).The 3-month continuous abstinence rate at 6 month was higher in the group with Varenicline (31.3% versus 18.2% ; OR=2.04,95% CI:1.46-2.86; P<0.001).Varenicline also showed better outcomes at 1 and 3 month follow-up.Conclusion Varenicline prescription in the smoking cessation clinic appeared to be effective that doubled the rates of quitting among Chinese smokers in the practice at a community-based SCC.