Developments in smoking cessation interventions for patients with chronic obstructive pulmonary disease in the past 5 years: a scoping review

Smoking cessation is the most effective strategy for slowing the progression of chronic obstructive pulmonary disease (COPD). However, COPD patients find it difficult to quit smoking with standard cessation interventions. A scoping review of smoking cessation for COPD patients was conducted by searching the MEDLINE, Embase, and Cochrane Library databases for all studies published between 1 January 2016 and 22 September 2021. Four themes were set up and 47 studies were included eventually. The majority of the included studies (61.7%, 29/47) investigated efficacy and effectiveness, including new strategies for extended treatment and mobile health (mHealth) delivery approach. Studies examining accessibility and utilization (31.9%, 15/47), safety (10.6%, 5/47), and health economics (6.4%, 3/47) were also reviewed. The quality of the included randomized controlled trials was also evaluated. Pharmacotherapy combined with behavioral interventions delivered via mHealth may be a promising strategy to help COPD smokers quit. However, the overall quality of the current studies is poor, making it challenging for clinicians to make informed decisions. Future high-quality studies are needed to provide conclusive evidence on the optimal pharmacotherapies and the most cost-effective comprehensive smoking cessation interventions, particularly those integrated into disease management for smokers with COPD.

戒烟是延缓慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）进展的最有效策略。然而，采用标准戒烟干预措施的慢阻肺患者往往难以成功戒烟。本研究针对慢阻肺患者的戒烟干预开展了范围综述（scoping review），检索了MEDLINE、Embase及Cochrane Library三大数据库，纳入2016年1月1日至2021年9月22日期间发表的全部相关研究，最终确立4个研究主题并纳入47项文献。
纳入的研究中，多数（61.7%，29/47）聚焦于干预效果与效能评估，涵盖延长治疗的新型策略以及移动健康（mobile health, mHealth）干预手段。另有研究分别探讨了干预的可及性与使用情况（31.9%，15/47）、安全性（10.6%，5/47）及卫生经济学价值（6.4%，3/47）。本研究同时对纳入的随机对照试验的研究质量进行了评价。
研究结果显示，联合药物治疗与通过移动健康平台实施的行为干预，或是帮助慢阻肺吸烟者戒烟的潜在有效策略。但当前现有研究的整体质量偏低，使得临床医师难以据此做出循证决策。未来亟需开展高质量研究，以明确最优药物治疗方案与最具成本效益的综合戒烟干预手段，尤其是那些整合进慢阻肺吸烟者疾病管理体系的干预策略。