2024世界卫生组织成人戒烟临床治疗指南报告（英）

WHOclinicaltreatmentguidelinefortobaccocessationinadults 1 30sec–3min 2 100% 3 +AI MONTH 4 Varenicline/ / bupropioncytisine NRT 5 Bupropion+ /Varenicline NRT 6 7 Varenicline / NRT 8 + 9 +? 10 11 ❶+❸X ?X YESNO ❷+❺ 12 3 4 2 5 1 6 12 7 11 8 10 9 WHOclinicaltreatmentguidelinefortobaccocessationinadults WHOclinicaltreatmentguidelinefortobaccocessationinadultsISBN978-92-4-009643-1(electronicversion) ISBN978-92-4-009644-8(printversion) ©WorldHealthOrganization2024 Somerightsreserved.ThisworkisavailableundertheCreativeCommonsAttribution-NonCommercial-ShareAlike3.0IGOlicence(CCBY-NC-SA3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Underthetermsofthislicence,youmaycopy,redistributeandadapttheworkfornon-commercialpurposes,providedtheworkisappropriatelycited,asindicatedbelow.Inanyuseofthiswork,thereshouldbenosuggestionthatWHOendorsesanyspecificorganization,productsorservices.TheuseoftheWHOlogoisnotpermitted.Ifyouadaptthework,thenyoumustlicenseyourworkunderthesameorequivalentCreativeCommonslicence.Ifyoucreateatranslationofthiswork,youshouldaddthefollowingdisclaimeralongwiththesuggestedcitation:“ThistranslationwasnotcreatedbytheWorldHealthOrganization(WHO).WHOisnotresponsibleforthecontentoraccuracyofthistranslation.TheoriginalEnglisheditionshallbethebindingandauthenticedition”. AnymediationrelatingtodisputesarisingunderthelicenceshallbeconductedinaccordancewiththemediationrulesoftheWorldIntellectualPropertyOrganization(http://www.wipo.int/amc/en/mediation/rules/). Suggestedcitation.WHOclinicaltreatmentguidelinefortobaccocessationinadults.Geneva:WorldHealthOrganization;2024.Licence:CCBY-NC-SA3.0IGO. Cataloguing-in-Publication(CIP)data.CIPdataareavailableathttps://iris.who.int/. Sales,rightsandlicensing.TopurchaseWHOpublications,seehttps://www.who.int/publications/book-orders.Tosubmitrequestsforcommercialuseandqueriesonrightsandlicensing,seehttps://www.who.int/copyright. Third-partymaterials.Ifyouwishtoreusematerialfromthisworkthatisattributedtoathirdparty,suchastables,figuresorimages,itisyourresponsibilitytodeterminewhetherpermissionisneededforthatreuseandtoobtainpermissionfromthecopyrightholder.Theriskofclaimsresultingfrominfringementofanythird-party-ownedcomponentintheworkrestssolelywiththeuser. Generaldisclaimers.ThedesignationsemployedandthepresentationofthematerialinthispublicationdonotimplytheexpressionofanyopinionwhatsoeveronthepartofWHOconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedanddashedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement. Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimplythattheyareendorsedorrecommendedbyWHOinpreferencetoothersofasimilarnaturethatarenotmentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistinguishedbyinitialcapitalletters. AllreasonableprecautionshavebeentakenbyWHOtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallWHObeliablefordamagesarisingfromitsuse. i TableofContents Acknowledgementsiii Abbreviationsandacronymsv Glossaryoftermsvii Executivesummaryxi Backgroundxi Rationaleandobjectivesxi Guidelinedevelopmentprocessandmethodsxi Targetaudiencexi Summaryofrecommendationsxii Behaviouralsupportdeliveredinbothclinicalandcommunitysettingsxiii Digitaltobaccocessationinterventionsxiii Pharmacologicalinterventionsdeliveredinbothclinicalandcommunitysettingsxiii Interventionsforsmokelesstobaccousecessationxiv Combinationofbehaviouralandpharmacologicaltreatmentsxiv Traditional,complementaryandalternativetherapiesxiv System-levelinterventionsandpoliciesxiv 1.Introduction1 1.1.ExistingWHOguidelines1 1.2.Rationaleandobjectives2 1.3.Targetaudience3 2.Methods5 2.1.Scopeoftheguidelineandquestionsofinterest5 2.2.Evidencereviews6 2.3.Assessmentofevidenceanditsgrading8 2.4.Goingfromevidencetorecommendations8 3.Recommendations11 3.1.Behaviouralsupportdeliveredinbothclinicalandcommunitysettings11 3.1.1.Recommendations11 3.1.2.Overallquestions11 3.1.3.Justificationandevidence11 3.1.4.Implementationconsiderations13 3.2.Digitaltobaccocessationinterventions14 3.2.1.Recommendation14 3.2.2.Overallquestions14 3.2.3.Justificationandevidence14 3.2.4.Implementationconsiderations16 3.3.Pharmacologicalinterventionsdeliveredinbothclinicalandcommunitysettings17 3.3.1.Recommendations17 3.3.2.Overallquestions17 3.3.3.Justificationandevidence17 3.3.4.Implementationconsideration21 ii 3.4.Interventionsforsmokelesstobaccousecessation22 3.4.1.Recommendations22 3.4.2.Overallquestions22 3.4.3.Justificationandevidence22 3.4.4.Implementationconsiderations23 3.5.Combinationofbehaviouralandpharmacologicaltreatments23 3.5.1.Recommendation23 3.5.2.Overallquestions23 3.5.3.Justificationandevidence23 3.5.4.Implementationconsiderations24 3.6.Trad