戒菸方案之隨機控制試驗之系統性文獻回顧

Randomized controlled trials for smoking cessation: a systematic review

吸菸對於健康有相當程度危害，戒菸一直是衛生健康單位關心的議題，然而科技媒介介入與傳統戒菸方案之成效差異的研究仍不足。本研究目的是透過系統性文獻回顧以探討現有戒菸方案之成效。本研究搜尋近三年研究，篩選後共收錄36篇文獻，其中藥物與尼古丁替代療法類23篇，科技媒介介入方式4篇及非科技媒介介入方式9篇。非尼古丁藥物於六個月與一年追蹤戒菸率分別可達47.4％和26.8％，最常使用的藥物為戒必適與威博雋。尼古丁替代療法六個月與一年追蹤戒菸率分別可達33.3％和30.0％，最常使用為尼古丁貼片及口嚼錠。科技媒介介入方式以電話簡訊最多，六個月戒菸率可達30％。非科技媒介介入方式則以包含認知行為治療的合併式療法最多，六個月追蹤戒菸率可達57.1％。藥物和尼古丁替代療法需注意其副作用和成癮問題，而科技媒介和非科技媒介介入方式則有個案順從性的考量。本研究透過系統性回顧探討不同戒菸介入方案的優點和限制，有助未來發展多元化戒菸方案之參考。

Smoking poses a great threat to health, and smoking cessation is always a critical concern of health authorities; however, the effectiveness of smoking cessation programs has been limited. The aim of this study was to systematically review the literature related to smoking cessation programs. We searched for randomized controlled trial studies related to smoking cessation in the last 3 years, and 36 articles were reviewed. They were categorized into 3 types: 23 medication interventions (non-nicotine medicine/nicotine medicine), 9 non-technological interventions, and 4 technology-based interventions. The average cessation rate was higher with the non-nicotine medication approach than with the others. The 6-month and 1-year cessation rate were 47.4% and 26.8%, respectively. Varenicline and bupropion were the most commonly prescribed medications. The 6-month and 1-year cessation rates for nicotine replacement therapies were 33.3% and 30.0%, respectively. Nicotine patches and gum were used most frequently. Among the technology-based interventions, the telephone and text approach was used most often. The cessation rate could reach 30.0%. Of non-technological interventionss, cognitive-behavioral therapies were most common. The 6-month cessation rate could reach 57.1%. The side-effects and addiction potential of medications and nicotine replacement therapies should be noted. The results of the literature review revealed that there were strengths and limitations of the various interventions. Through the development of diverse intervention programs, we may be able to reach more people who need to cease smoking.