天津市戒烟门诊158名就诊吸烟者戒烟状况调查

目的 了解天津市戒烟门诊就诊吸烟者的人群特点、吸烟情况、戒烟情况,为更有效的开展戒烟门诊服务提供科学依据。方法 调查前来三家戒烟门诊就诊的158名吸烟者,并于一个月后进行随访。结果 就诊吸烟者中50%(79/158)是通过医生推荐或转诊至戒烟门诊,47.5%(75/158)决定戒烟的原因是自身患病,59.5%(94/158)的人尝试过戒烟;就诊吸烟者的平均烟龄为19.5年,平均每日吸烟量为16.3支;一个月随访的应答率为86.7%(137/158),一个月随访的时点戒烟率为43.1%(59/137),未戒烟者的一个月时点减烟率为56.4%(44/78);27.0%(37/137)的人认为医生或药物对其戒烟帮助最大。结论 天津市戒烟门诊能提高吸烟者的戒烟率,但目前就诊人数较少,还应继续加大戒烟门诊的宣传力度。     

上海市公务人员戒烟大赛一年期干预效果研究

【目的】评估2015年度上海市公务人员戒烟大赛的1年随访效果,探讨复吸行为的影响因素,为保持戒烟干预效果提供参考和依据。【方法】采用病例对照研究设计,对阶段性戒烟成功者开展问卷调查。【结果】戒烟大赛1年随访复吸率为19.70%,79.49%的复吸者在戒烟后2个月内复吸,受教育程度为复吸的危险因素。复吸主要原因为吸烟朋友的压力、烟瘾发作。【结论】本次大赛1年随访复吸率处于较低水平,戒烟效果良好。受教育程度为复吸行为的危险因素。     

2015-2018年央补项目戒烟门诊患者首诊后1个月随访时戒烟率影响因素分析

目的 评估中央补助地方戒烟门诊项目实施效果,探索影响吸烟者戒烟成功的因素,以指导戒烟服务的提供和戒烟门诊工作的开展。方法 采用人群现场干预研究,由经过项目培训的医务人员,对吸烟者进行面对面访谈,完成调查问卷,并进行心理行为干预。已配备戒烟药物的医院,为患者开具相应药物。首诊1个月后开展随访干预,获得1个月随访7 d时点戒烟率。结果 1个月随访7 d时点戒烟率为34.1%。多元logistic回归结果显示, ≥60岁患病人群戒烟可能性最大;自身患病、首诊非每天吸烟、准备在30 d内戒烟、使用酒石酸伐尼克兰和盐酸安非他酮的患者,戒烟成功的可能性更大;未就业者相对于就业者更不利于戒烟;每日吸烟量越大、吸烟年限越长、晨起后第一支烟越急迫的患者,戒烟的可能性越小;是否有戒烟史对戒烟可能性没有影响。结论 从1个月随访时7 d时点戒烟率看,央补戒烟门诊项目戒烟干预有效。应加大对吸烟者的宣传,戒烟越早越有效。使用酒石酸伐尼克兰和盐酸安非他酮等药物能增加戒烟的可能性,应加强戒烟门诊有效药物的配备率。戒烟门诊医务人员帮助患者在戒烟过程中克服戒断症状很重要。     

成都市戒烟门诊1个月随访效果评价

目的:了解、评价成都市戒烟门诊戒烟效果,探讨有效戒烟行为干预方法。方法:1个月后对在6家医院戒烟门诊接受戒烟干预的344名吸烟者进行电话随访,随访内容为个人吸烟习惯的改变、戒烟进度、戒烟过程中遇到的困难、对提供的戒烟服务满意情况等。结果:共有314人接受随访,1个月戒烟率为7.6%,随访者每天吸烟者的所占比例由基线时90.6%降低到48.1%,吸烟量也明显减少。76.1%随访者在过去7天内出现了戒烟症状,72.9%随访者认为门诊提供的辅导服务对其帮助最大。结论:戒烟门诊应充分发挥戒烟专业机构戒烟专业指导作用,为吸烟者提供更好的戒烟建议;在吸烟者戒烟1个月后应强化"帮助"和"随访"策略,预防复吸。     

江西省部分地区结核病患者吸烟状况调查

目的了解江西省部分地区结核病患者吸烟情况及戒烟意愿,为今后对结核病患者进行戒烟干预提供信息。方法对江西省部分地区2011年3月1日—8月31日间就诊并被确诊为结核病的所有患者进行问卷调查。结果 800名结核病患者中,总吸烟率为45.90%,男性、女性吸烟率分别为62.40%和0;367名结核病吸烟患者中,平均开始吸烟年龄为(19.8±6.2)岁,平均每天吸烟为(22.3±11.5)支;57.49%的吸烟患者有烟瘾;戒烟成功者占27.25%;46.05%的吸烟患者以前戒过烟;63.49%的吸烟患者表示愿意从现在开始戒烟。结论江西省部分地区肺结核病患者吸烟情况比较严重,需进一步加强对肺结核病患者进行烟草危害知识的健康教育。     

成都市戒烟门诊随访效果分析

目的 了解、评价成都市戒烟门诊戒烟效果,探讨有效戒烟行为干预方法.方法 2010年对在成都市6家医院戒烟门诊接受戒烟干预的344名吸烟者3个月后进行电话随访,随访内容为个人吸烟习惯的改变、戒烟进度、戒烟过程中遇到的困难、对提供的戒烟服务满意情况等.结果 共有310人接受随访,3个月戒烟率仅为9.7％,但随访者每天吸烟者的所占比例由基线时90.6％降低到71.0％,吸烟量由平均每天16.6支降低至8.8支.74.2％随访者在过去7d内出现了戒烟症状.结论 成都市戒烟门诊吸烟者3个月戒烟率较低,但每天吸烟量减少,戒烟专业机构应加强专业指导作用,为吸烟者提供更好的戒烟建议,以进一步提高戒烟成功率.     

戒烟门诊男性吸烟者成功戒烟的影响因素分析

目的 分析影响戒烟门诊男性吸烟者成功戒烟的相关因素。方法 由经培训的医生对自愿在戒烟门诊就医的吸烟者进行面对面咨询和心理干预, 之后进行1 周、1 个月、3 个月和6个月4 次标准化的电话随访干预。6 个月随访时主要分析指标为“7 天时点戒烟率”和“3 个月持续戒烟率”及其相关影响因素。结果 2008 年10 月至2012 年12 月共有355 人入组, 其中255 人完成6 个月随访。符合方案样本（n＝255）的“7 天时点戒烟率”和“3 个月持续戒烟率”分别为34.9%和25.5%, 而意向性分析样本（n＝355）则分别为25.1%和18.3%。logistic 多元分析结果显示, 戒烟成功与首诊呼气一氧化碳测试水平低、戒烟信心自评分高、买烟费用低、伴有医生诊断的烟草相关慢性病呈正相关。戒烟失败的主要原因是无法克服烟瘾、需要用吸烟缓解工作压力、受到身边其他吸烟者的影响, 以及缺乏戒烟的心理准备和毅力等。结论 吸烟量较少、戒烟自信心强、患有烟草相关慢性病的男性吸烟者较易成功戒烟, 应为吸烟者提供定期的随访干预服务, 增强其戒烟动机和创造良好的戒烟环境。     

医生指导对慢性阻塞性肺疾病患者戒烟的作用

目的探讨医生指导对慢性阻塞性肺疾病（COPD）患者戒烟的作用。方法对70例COPD吸烟患者进行戒烟指导,并定期电话随访,每隔3个月检测肺功能及呼出气一氧化碳浓度评估戒烟情况。结果70例COPD患者随访6个月,其中28例（40．00％）戒烟,戒烟时间达6个月;17例（24．28％）戒烟一段时间后复吸,最初戒烟时间平均为（3．08±0．33）个月,复吸后烟量与戒烟前相同,经劝导后5例再次尝试戒烟,12例减少烟量;16例（22．86％）患者虽未彻底戒烟,但日吸烟支数平均较前下降60％;9例（12．86％）吸烟习惯较前无改变。结论医生指导能够提高COPD患者的戒烟率。干预力度愈大,戒烟成功率愈高。     

戒烟干预对吸烟者知识、态度和行为的影响

目的 评价戒烟干预对戒烟门诊求助者烟草相关知识、态度和行为(知、信、行)的影响。方法 以2008年10 月至2013 年8月解放军总医院戒烟门诊就医的未使用戒烟药物的吸烟者为研究对象,戒烟门诊医师首诊时为吸烟者进行≥30 min的面对面咨询和心理干预,之后1周、1个月、3个月和6个月时共进行4次随访电话干预(每次15～20 min).对照组为2012 年8月至2013 年8月解放军总医院健康医学中心某病区常规查体的吸烟者,基线和随访时均不进行干预。比较基线和1年随访时干预组和对照组烟草相关知、信、行的变化情况。结果 干预组和对照组分别纳入414例和213例研究对象。意向性分析显示,干预组1年随访烟草相关知、信方面共有5个变量的知晓/同意率高于基线。两组的1年随访时点戒烟率分别为4.7%和27.3%.logistic 多元回归分析显示,1年随访时戒烟率与暴露于戒烟干预、女性、尼古丁依赖评分低和烟草相关知识及态度正向变化(吸烟导致心脏病、应该禁止各种形式的烟草产品推广、吸烟浪费金钱和酒楼、饭店应该全面禁烟)共7个变量呈正相关,其OR值(95%CI)分别为2.85(2.00～4.07)、3.34(1.23～9.07)、2.78(1.64～4.72)、2.30(1.03～5.15)、5.33(1.47～19.32)、6.32(1.56～25.62)和10.47(2.25～48.84).结论 戒烟门诊求助者的烟草危害认知水平普遍较高,通过系统化戒烟干预,部分吸烟者知识及态度有了一定提高。烟草相关知识及态度的有益转变,有利于提高戒烟率。     

中国三城市男性吸烟者的社会规范与戒烟行为的关系

【目的】了解中国男性戒烟相关社会规范的现状及其与戒烟意愿、戒烟尝试等戒烟行为之间的关系。【方法】基于横断面研究,于2013年8-11月在上海、南宁、牡丹江三个地区抽取成年男性现在吸烟者进行问卷调查,收集基本信息、每日吸烟量、戒烟意愿、戒烟尝试和戒烟相关社会规范等资料。建立单因素、多因素logistic回归模型分别分析戒烟相关社会规范与戒烟意愿、戒烟尝试的关系。共获得有效问卷3621份,总有效率95.8%。【结果】吸烟者感知到的戒烟相关社会规范较低,很少能从家人、朋友及其他身边的人获得戒烟的劝谏与建议。社会规范得分每提高1分,则吸烟者的戒烟意愿可能性增加69%(OR为1.69,95%CI为1.48~1.94),吸烟者戒烟尝试的可能性增加86%(OR为1.86,95%CI为1.66~2.08)。【结论】戒烟相关社会规范是吸烟者产生戒烟意愿、戒烟尝试的独立预测因子。今后的控烟干预策略应该致力于创建鼓励戒烟的社会规范。     

Changes in smoking among restaurant and bar employees following Norway's comprehensive smoking ban

Norway implemented a nationwide ban on indoor smoking in June 2004. This study documents the smoking patterns of Norway's restaurant and bar workers before and after the ban, to determine changes in smoking prevalence and explore which individual and environmental characteristics were related to cessation. A national sample of food service workers was surveyed by telephone or Internet immediately before the ban and at 4 and 11 months post-implementation. Results showed that between baseline measurement and 4 months post-implementation, there were significant declines in prevalence of daily smoking (-3.6% points, p < 0.005), daily smoking at work (-6.2% points, p < 0.001), number of cigarettes smoked by continuing smokers (-1.55, p < 0.001) and number of cigarettes smoked at work by continuing smokers (-1.63, p < 0.001). No significant changes occurred in any of these variables between 4 and 11 months post-implementation. Logistic regression analysis revealed that only smokers' intentions at baseline to quit within 30 days predicted cessation at both follow-up time points. In addition, cessation at 4 months was predicted by lower daily cigarette consumption at baseline, whereas cessation at 11 months was predicted by baseline attitude toward ETS and exposure to ETS as measured at follow-up. In sum, Norway's smoking ban was accompanied by a reduction in smoking in the period immediately following the ban, and the reduction was maintained almost a year later. The finding that smoking cessation was consistently associated with smokers' intentions to quit within 30 days suggests that motivational and support programs could play a significant role in boosting cessation rates. It is recommended that targeted interventions be used to supplement the benefits of a comprehensive ban to achieve tobacco control objectives.     

广州市初中男生尝试戒烟和戒烟成功的影响因素

目的了解初中男生的尝试戒烟率、戒烟成功率及其影响因素。方法用自填式问卷对4658名初中男生进行横断面调查,收集人口学资料、学校情况、有关吸烟与健康的知识和态度以及个人吸烟和戒烟行为等信息。结果初中男生的规律吸烟率为7·6%,68·6%的规律吸烟男生在过去12个月中尝试过戒烟,戒烟成功率为17·2%。前两位的戒烟动机是“吸烟会影响健康”和“有人劝我戒烟”。筛选出4个有统计学意义的影响尝试戒烟的因素,促进戒烟的有“曾经被人劝戒烟”、“健康缘故”、“心情不好时才吸烟”和“父母反对吸烟”等。另外,有2个影响因素与戒烟成功有统计学关联:“曾接触过反烟宣传”能促使戒烟成功,而“经常在校外吸烟”是阻碍因素。结论大部分规律吸烟者尝试过戒烟,但成功率低。应根据青少年的生理和心理特点,整合学校、家庭和社会等多方力量来帮助其成功戒烟。     

Reported cessation advice given to African Americans by health care providers in a community health clinic

Physician smoking cessation advice has been shown to be effective in encouraging patients to attempt cessation. Few studies have examined factors associated with patient-reported physician advice in an inner city community health clinic. Smokers identified via chart review and provider referral met with a study smoking specialist. Eligible participants self-identified as African American, smoked at least 1 cigarette per day in the prior 7 days, were 18 or older, had access to a telephone, and agreed to consider blood testing for genetic susceptibility to lung cancer. Of the 869 smokers identified, 487 were eligible and completed a brief in-person and a more extensive follow-up telephone survey within one week after their visit. Patient reports of smoking cessation advice by providers were regressed on patient demographic, smoking, health, and social support variables. Seventy percent of participants reported that they had been advised to quit smoking. Smokers who were older, did not smoke menthol cigarettes, were in poorer health, and who had a regular health care provider were most likely to report having received advice. Patients in this community health setting reported high rates of provider advice to quit smoking. Yet, even in this optimal condition, young healthy smokers did not report receiving advice, even when they were ready to quit smoking. Providers may need additional training and prompting to counsel young healthy smokers about the importance of cessation.     

Dependency, social factors, and the smoking cessation process: the doctors helping smokers study

We analyzed data obtained from a representative sample of the smoking patients (n = 1,338) of 66 family physicians to determine predictors of attempts to stop smoking, desire to quit smoking, and successful smoking cessation. Compared to subjects who made no attempt to quit smoking, subjects who tried to quit smoking tended to be younger, had tried to quit smoking in the year prior to the study, waited longer before smoking their first cigarette of the day, had more desire to quit smoking, and had more social support for quitting. Education and cigarettes smoked per day were not independently related to the subject making a quit attempt. Desire to quit smoking was associated with an attempt to quit in the year prior to the study and social support for smoking cessation (support of spouse, second most important social contact, and physician). Desire to quit smoking was not independently related to age, education, or dependency on cigarettes (measured by the number of cigarettes smoked per day and the length of time a subject waited before smoking the first cigarette of the day). Compared to subjects who tried to quit and failed, subjects who succeeded were older, smoked fewer cigarettes per day, and waited longer to smoke their first cigarette of the day. Spouse support, support of the second most important social contact, and advice of a doctor to quit smoking were not independently related to whether or not a cessation attempt would be successful. These data suggest that successful smoking cessation requires two components: social support to make an attempt to quit and the ability to overcome dependency on cigarettes to make the attempt successful.     

A smoking cessation intervention among tuberculosis patients in rural China

Objective: To assess the integration of a smoking cessation intervention into routine tuberculosis (TB) services.Method: Consecutive TB patients registered from 1 March to 31 August 2010 were enrolled in an intervention for self-reported smoking to promote tobacco cessation during treatment for TB. Information on the harmful health effects of tobacco smoke and smoking and TB were provided to TB patients who self-reported as current smokers. Smoking status was reassessed at every follow-up visit during anti-tuberculosis treatment with reinforced health messages and advice to quit.Results: Of 800 TB patients enrolled, 572 (71.5%) were male and 244 (30.5%) were current smokers. Females were more likely to be non-smokers (100% vs. 35.8%, P < 0.001). Of the 244 current smokers, 144 (59.0%) started smoking at <20 years, 197 (80.7%) consumed ⩾20 cigarettes per day, 211 (86.5%) had perceived smoking dependence and 199 (81.6%) had made no attempt to quit before the diagnosis of TB. Of the 244 current smokers, 234 (95.9%) were willing to quit, and 156 (66.7%) reported abstinence at month 6. Challenges to implementing smoking cessation intervention were identified.Conclusion: The majority of current smokers among TB patients were willing to quit and remained abstinent at the end of anti-tuberculosis treatment. This intervention should be scaled up nationwide.     

Establishment and evaluation of a smoking cessation clinic in Hong Kong: a model for the future service provider

BACKGROUND: In the West, the effectiveness of smoking cessation programmes is well established. Smoking cessation programmes in the East are rare. We evaluated a pilot smoking cessation health centre (SCHC) of the Hong Kong Council on Smoking and Health (COSH). METHODS: The clinic operated 3 days a week from 6 to 9 pm. Smokers were recruited mainly by low cost publicity. Trained counsellors provided individual counselling and a 1 week free supply of nicotine replacement therapy (NRT). The programme was evaluated in terms of process, outcome and cost. RESULTS: During August 2000 to January 2002, 2212 calls were received through the clinic hotline and 1203 smokers attended the clinic. Eight hundred and forty-one were successfully followed up at 12 months. Based on intention-to-treat analysis, the 7 day point prevalence quit rate at 12 months (not smoking any cigarette during the past 7 days at the 12 month follow-up) was 27 per cent (95 per cent confidence interval, CI 25-30 per cent). The average cost per quitter was USD 339 (USD 440 including NRT cost for a 1 week free supply). Other benefits included training of healthcare workers and medical students, organization of seminars, health talks and self-help groups, and promotion of research and training. CONCLUSION: This first evaluation of a clinic-based smoking cessation service in Asia showed that the service was acceptable to Chinese smokers. The quit rate in this pilot part-time clinic is comparable to those of full-time and better funded clinics in the West. A part-time smoking cessation clinic is a promising model for piloting smoking cessation services in the East.     

The use of nicotine patches with minimal intervention

BACKGROUND: This paper describes a natural, prospective, open-label study designed to evaluate the impact of free nicotine patches with minimal support for smoking cessation. METHODS: Surveys were administered to 223 participants who received nicotine patches from the American Lung Association. All participants received a 6-week supply of 15-mg/16-h transdermal nicotine patches, a self-help book Freedom from Smoking, and information about area smoking cessation classes. Follow-up telephone surveys were administered 6 weeks after the patches were distributed. Abstinence was measured through self-report exclusively. RESULTS: The overall quit rate at 6-weeks was 21% (47/223). Among nonquitters, the mean number of cigarettes smoked per day dropped from 25 at baseline to 14 at 6 weeks. There was a significant difference in the average number of patches used by quitters and nonquitters (26 versus 11, P < 0.001). CONCLUSIONS: Nicotine patches with minimal support can be effective in smoking cessation and smoking reduction. The availability of patches may have motivated participants to quit. Efforts to increase access to and use of nicotine patches may result in increased attempts to quit and successful quitting.