PDF(Pubmed)
Abstract：
UNASSIGNED: Socioeconomically disadvantaged individuals (ie, those with low socioeconomic status [SES]) have difficulty quitting smoking and may benefit from incentive-based cessation interventions.
UNASSIGNED: To evaluate the impact of incentivizing smoking abstinence on smoking cessation among adults with low SES.
UNASSIGNED: This study used a 2-group randomized clinical trial design. Data collection occurred between January 30, 2017, and February 7, 2022. Participants included adults with low SES who were willing to undergo smoking cessation treatment. Data were analyzed from April 18, 2023, to April 19, 2024.
UNASSIGNED: Participants were randomized to usual care (UC) for smoking cessation (counseling plus pharmacotherapy) or UC plus abstinence-contingent financial incentives (UC plus FI).
UNASSIGNED: The primary outcome was biochemically verified 7-day point prevalence smoking abstinence (PPA) at 26 weeks after the quit date. Secondary outcomes included biochemically verified 7-day PPA at earlier follow-ups, 30-day PPA at 12 and 26 weeks, repeated 7-day PPA, and continuous abstinence. Multiple approaches were employed to handle missing outcomes at follow-up, including categorizing missing data as smoking (primary), complete case analysis, and multiple imputation.
UNASSIGNED: The 320 participants had a mean (SD) age of 48.9 (11.6) and were predominantly female (202 [63.1%]); 82 (25.6%) were Black, 15 (4.7%) were Hispanic, and 200 (62.5%) were White; and 146 (45.6%) participated during the COVID-19 pandemic. Overall, 161 were randomized to UC and 159 were randomized to UC plus FI. After covariate adjustment with missing data treated as smoking, assignment to UC plus FI was associated with a greater likelihood of 7-day PPA at the 4-week (adjusted odds ratio [AOR], 3.11 [95% CI, 1.81-5.34]), 8-week (AOR, 2.93 [95% CI, 1.62-5.31]), and 12-week (AOR, 3.18 [95% CI, 1.70-5.95]) follow-ups, but not at the 26-week follow-up (22 [13.8%] vs 14 [8.7%] abstinent; AOR, 1.79 [95% CI, 0.85-3.80]). However, the association of group assignment with smoking cessation reached statistical significance at all follow-ups, including 26 weeks, with multiple imputation (37.37 [23.5%] in the UC plus FI group vs 19.48 [12.1%] in the UC group were abstinent; AOR, 2.29 [95% CI, 1.14-4.63]). Repeated-measures analyses indicated that participants in the UC plus FI group were significantly more likely to achieve PPA across assessments through 26 weeks with all missing data estimation methods. Other secondary cessation outcomes also showed comparable patterns across estimation methods. Participants earned a mean (SD) of $72 ($90) (of $250 possible) in abstinence-contingent incentives. Participation during the COVID-19 pandemic reduced the likelihood of cessation across assessments.
UNASSIGNED: In this randomized clinical trial, incentivizing smoking cessation did not increase cessation at 26 weeks when missing data were treated as smoking; however, the UC plus FI group had greater odds of quitting at follow-ups through 12 weeks. Cessation rates were higher for the UC plus FI group at all follow-ups through 26 weeks when multiple imputation was used to estimate missing outcomes.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT02737566.
UNASSIGNED: To evaluate the impact of incentivizing smoking abstinence on smoking cessation among adults with low SES.
UNASSIGNED: This study used a 2-group randomized clinical trial design. Data collection occurred between January 30, 2017, and February 7, 2022. Participants included adults with low SES who were willing to undergo smoking cessation treatment. Data were analyzed from April 18, 2023, to April 19, 2024.
UNASSIGNED: Participants were randomized to usual care (UC) for smoking cessation (counseling plus pharmacotherapy) or UC plus abstinence-contingent financial incentives (UC plus FI).
UNASSIGNED: The primary outcome was biochemically verified 7-day point prevalence smoking abstinence (PPA) at 26 weeks after the quit date. Secondary outcomes included biochemically verified 7-day PPA at earlier follow-ups, 30-day PPA at 12 and 26 weeks, repeated 7-day PPA, and continuous abstinence. Multiple approaches were employed to handle missing outcomes at follow-up, including categorizing missing data as smoking (primary), complete case analysis, and multiple imputation.
UNASSIGNED: The 320 participants had a mean (SD) age of 48.9 (11.6) and were predominantly female (202 [63.1%]); 82 (25.6%) were Black, 15 (4.7%) were Hispanic, and 200 (62.5%) were White; and 146 (45.6%) participated during the COVID-19 pandemic. Overall, 161 were randomized to UC and 159 were randomized to UC plus FI. After covariate adjustment with missing data treated as smoking, assignment to UC plus FI was associated with a greater likelihood of 7-day PPA at the 4-week (adjusted odds ratio [AOR], 3.11 [95% CI, 1.81-5.34]), 8-week (AOR, 2.93 [95% CI, 1.62-5.31]), and 12-week (AOR, 3.18 [95% CI, 1.70-5.95]) follow-ups, but not at the 26-week follow-up (22 [13.8%] vs 14 [8.7%] abstinent; AOR, 1.79 [95% CI, 0.85-3.80]). However, the association of group assignment with smoking cessation reached statistical significance at all follow-ups, including 26 weeks, with multiple imputation (37.37 [23.5%] in the UC plus FI group vs 19.48 [12.1%] in the UC group were abstinent; AOR, 2.29 [95% CI, 1.14-4.63]). Repeated-measures analyses indicated that participants in the UC plus FI group were significantly more likely to achieve PPA across assessments through 26 weeks with all missing data estimation methods. Other secondary cessation outcomes also showed comparable patterns across estimation methods. Participants earned a mean (SD) of $72 ($90) (of $250 possible) in abstinence-contingent incentives. Participation during the COVID-19 pandemic reduced the likelihood of cessation across assessments.
UNASSIGNED: In this randomized clinical trial, incentivizing smoking cessation did not increase cessation at 26 weeks when missing data were treated as smoking; however, the UC plus FI group had greater odds of quitting at follow-ups through 12 weeks. Cessation rates were higher for the UC plus FI group at all follow-ups through 26 weeks when multiple imputation was used to estimate missing outcomes.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT02737566.
摘要：
■社会经济上处于不利地位的个人（即，那些社会经济地位低的人[SES]）难以戒烟，可能会从基于激励的戒烟干预措施中受益。
■评估鼓励戒烟对SES较低的成年人戒烟的影响。
■本研究采用2组随机临床试验设计。数据收集发生在2017年1月30日至2022年2月7日之间。参与者包括愿意接受戒烟治疗的SES较低的成年人。对2023年4月18日至2024年4月19日的数据进行了分析。
■参与者被随机分配到常规治疗（UC）戒烟（咨询加药物治疗）或UC加禁欲-或有经济奖励（UC加FI）。
■主要结果是在戒烟日期后26周时经生化验证的7天点吸烟戒烟（PPA）患病率。次要结果包括早期随访中生化验证的7天PPA，在12周和26周的30天PPA，重复7天PPA，和持续的禁欲。在随访中采用了多种方法来处理缺失的结果，包括将缺失数据分类为吸烟(主要)，完整的案例分析，和多重归责。
■320名参与者的平均年龄（SD）为48.9（11.6），主要为女性（202[63.1％]）；82（25.6％）为黑人，15人（4.7%）是西班牙裔，200人(62.5%)为白人；146人(45.6%)参与了COVID-19大流行。总的来说,161人被随机分配至UC，159人被随机分配至UC加FI。在将缺失数据视为吸烟的协变量调整后，分配至UC加FI与4周时7天PPA的可能性更大相关(调整后的优势比[AOR]，3.11[95%CI，1.81-5.34])，8周（AOR，2.93[95%CI，1.62-5.31])，和12周(AOR，3.18[95%CI，1.70-5.95])随访，但在26周的随访中没有(22[13.8%]对14[8.7%]的禁欲；AOR，1.79[95%CI，0.85-3.80]）。然而,分组与戒烟的关联在所有随访中均达到统计学意义，包括26周，多次填补（UC+FI组37.37[23.5%]vsUC组19.48[12.1%]；AOR，2.29[95%CI，1.14-4.63]）。重复测量分析表明，UC加FI组的参与者在26周的所有缺失数据估计方法的评估中获得PPA的可能性更大。其他次要戒烟结果也显示出不同估计方法的可比模式。参与者获得了72美元（90美元）（可能为250美元）的禁欲奖励的平均（SD）。参与COVID-19大流行降低了各种评估停止的可能性。
■在这项随机临床试验中，当缺失数据被视为吸烟时，激励戒烟并没有增加26周的戒烟；然而，UC+FI组在随访12周时退出的几率更大.在26周的所有随访中，当使用多重插补来估计缺失结果时，UC加FI组的戒烟率更高。
■ClinicalTrials.gov标识符：NCT02737566。
■评估鼓励戒烟对SES较低的成年人戒烟的影响。
■本研究采用2组随机临床试验设计。数据收集发生在2017年1月30日至2022年2月7日之间。参与者包括愿意接受戒烟治疗的SES较低的成年人。对2023年4月18日至2024年4月19日的数据进行了分析。
■参与者被随机分配到常规治疗（UC）戒烟（咨询加药物治疗）或UC加禁欲-或有经济奖励（UC加FI）。
■主要结果是在戒烟日期后26周时经生化验证的7天点吸烟戒烟（PPA）患病率。次要结果包括早期随访中生化验证的7天PPA，在12周和26周的30天PPA，重复7天PPA，和持续的禁欲。在随访中采用了多种方法来处理缺失的结果，包括将缺失数据分类为吸烟(主要)，完整的案例分析，和多重归责。
■320名参与者的平均年龄（SD）为48.9（11.6），主要为女性（202[63.1％]）；82（25.6％）为黑人，15人（4.7%）是西班牙裔，200人(62.5%)为白人；146人(45.6%)参与了COVID-19大流行。总的来说,161人被随机分配至UC，159人被随机分配至UC加FI。在将缺失数据视为吸烟的协变量调整后，分配至UC加FI与4周时7天PPA的可能性更大相关(调整后的优势比[AOR]，3.11[95%CI，1.81-5.34])，8周（AOR，2.93[95%CI，1.62-5.31])，和12周(AOR，3.18[95%CI，1.70-5.95])随访，但在26周的随访中没有(22[13.8%]对14[8.7%]的禁欲；AOR，1.79[95%CI，0.85-3.80]）。然而,分组与戒烟的关联在所有随访中均达到统计学意义，包括26周，多次填补（UC+FI组37.37[23.5%]vsUC组19.48[12.1%]；AOR，2.29[95%CI，1.14-4.63]）。重复测量分析表明，UC加FI组的参与者在26周的所有缺失数据估计方法的评估中获得PPA的可能性更大。其他次要戒烟结果也显示出不同估计方法的可比模式。参与者获得了72美元（90美元）（可能为250美元）的禁欲奖励的平均（SD）。参与COVID-19大流行降低了各种评估停止的可能性。
■在这项随机临床试验中，当缺失数据被视为吸烟时，激励戒烟并没有增加26周的戒烟；然而，UC+FI组在随访12周时退出的几率更大.在26周的所有随访中，当使用多重插补来估计缺失结果时，UC加FI组的戒烟率更高。
■ClinicalTrials.gov标识符：NCT02737566。
