AIM Aims were to test the effectiveness of an organizational change intervention integrating smoking cessation treatment into usual alcohol and other drug (AOD) treatment, compared with usual care, on 1) 7-day point prevalence abstinence (PPA) at 8 weeks follow-up; 2) prolonged abstinence; 3) cigarettes smoked per day; 4) number of quit attempts; and 5) offer and use of nicotine replacement therapy (NRT). All outcomes were assessed at 8 weeks and 6.5 months follow-up. DESIGN Cluster-randomized controlled trial, with AOD service as unit of randomization, conducted January 2015-March 2016. SETTING Thirty-two eligible services (provided face-to-face client sessions to ≥50 clients/year) in Australia were randomized to control (usual care; n=15) or intervention (n=17) groups by an independent blinded biostatistician. PARTICIPANTS Eligible participants (≥16yrs, current smoker) completed surveys at the service at baseline (n=896), and telephone follow-up surveys (conducted by blinded assessors) at 8-weeks (n=471; 53%) and 6.5-months (n=427; 48%). INTERVENTION Intervention services received an intervention to establish routine screening, assessment, and delivery of smoking cessation care. MEASUREMENTS Primary outcome was biochemically verified 7-day PPA at 8-week follow-up. Secondary outcomes included verified and self-reported prolonged abstinence, self-reported 7-day PPA, cigarettes/day, quit attempts, and offer and use of NRT. Intention-to-treat analyses were performed, assuming missing participants were not abstinent. FINDINGS At 8-weeks, the findings in verified 7-day PPA between groups (2.6% vs 1.8%, OR 1.72, 95%CI 0.5-5.7, p=0.373) were inconclusive as to whether a difference was present. Significantly lower mean cigarettes/day were reported in the intervention group compared to the usual care group at 8-weeks (15 vs. 16, incidence rate ratio [IRR]0.88, 95%CI 0.8-0.95, p=0.001) but were similar at 6.5-months (15 vs. 16, IRR 0.96, 95%CI 0.9-1.02, p=0.240) follow-up. At both follow-ups the intervention group reported higher rates of NRT use. CONCLUSIONS Integrating smoking cessation treatment into addiction services did not significantly improve short-term abstinence from smoking.

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在酒精和其他药物治疗中心增加戒烟护理的效果：一项整群随机对照试验

AIM 目的是测试将戒烟治疗与常规酒精和其他药物 (AOD) 治疗相结合的组织变革干预措施的有效性，与常规护理相比，1) 8 周随访时的 7 天点戒断流行率 (PPA) ; 2) 长期禁欲；3) 每天抽的香烟；4) 尝试退出的次数；5) 提供和使用尼古丁替代疗法 (NRT)。所有结果均在 8 周和 6.5 个月的随访中进行评估。设计 集群随机对照试验，以 AOD 服务为随机单位，于 2015 年 1 月至 2016 年 3 月进行。 （常规护理；n=15）或干预（n=17）组由独立的盲法生物统计学家组成。参与者 符合条件的参与者（≥16 岁，当前吸烟者）在基线时（n=896）完成了服务调查，并在 8 周（n=471；53%）和 6.5 周时完成了电话随访调查（由盲法评估者进行）个月（n=427；48%）。干预 干预服务接受干预以建立常规筛查、评估和提供戒烟护理。测量 主要结果是 8 周随访时生化验证的 7 天 PPA。次要结果包括经过验证和自我报告的长期戒烟、自我报告的 7 天 PPA、每天卷烟、戒烟尝试以及提供和使用 NRT。进行了意向性治疗分析，假设缺失的参与者不禁欲。结果 在第 8 周时，组间经过验证的 7 天 PPA 的结果（2.6% 对 1.8%，OR 1.72，95%CI 0.5-5.7，p=0。373）对于是否存在差异尚无定论。与常规护理组相比，干预组在 8 周时报告的平均卷烟/天显着降低（15 对 16，发病率比 [IRR] 0.88，95% CI 0.8-0.95，p=0.001）但相似在 6.5 个月（15 对 16，IRR 0.96，95% CI 0.9-1.02，p=0.240）的随访中。在两次随访中，干预组都报告了更高的 NRT 使用率。结论 将戒烟治疗纳入成瘾服务并没有显着改善短期戒烟。p=0.240) 随访。在两次随访中，干预组都报告了更高的 NRT 使用率。结论 将戒烟治疗纳入成瘾服务并没有显着改善短期戒烟。p=0.240) 随访。在两次随访中，干预组都报告了更高的 NRT 使用率。结论 将戒烟治疗纳入成瘾服务并没有显着改善短期戒烟。