北京市和平里医院职工吸烟状况及医护人员控烟能力调查

目的了解北京市和平里医院职工与吸烟有关的知识、态度、行为以及医护人员控烟技能和参与控烟工作的态度。方法采用㈣设计的医务人员控烟能力调查表和自行设计的职工行为危险因素调查表对医院职工进行调查。结果男性吸烟率为58．2％，女性1．7％，职工对吸烟具体危害健康的知识知晓率较低，88．1％的医护人员认为应该帮助吸烟人戒烟，实际有41．0％的医护人员为吸烟人提供了戒烟的帮助。结论医院应提高医务人员及全院职工对吸烟危害健康的认识，提高医护人员控烟的能力。     

上海市闵行区社区医院职工吸烟行为干预效果研究

目的探索医院吸烟行为干预模式并评价干预效果。方法在闵行区选择3家人口构成、吸烟率相似的社区卫生服务中心，随机分为3组，以其所有职工为研究对象。对照组按照无烟医院标准进行管理；干预组1实施为期一年的控烟行政措施干预方法；干预组2实施为期一年的控烟技能培训干预方法。在干预前后进行问卷调查评价干预效果。结果干预后，2个干预组在吸烟有害因素知晓率、控烟知识和技能掌握情况以及吸烟行为方面均有较大改善，其中干预组l的吸烟率下降了4．2％，干预组2的吸烟率下降了6．0％，对照组的吸烟率上升了7．0％，干预组1和2的吸烟率均明显低于对照组；两个干预组对病人进行戒烟指导的情况无明显变化，仍以简单指导为主。结论在医院中开展控烟干预，可以降低医务人员的吸烟率，弥补了无烟医院建设在长效管理中出现的薄弱环节。     

北京市房山区医务人员控烟干预效果评价

目的了解北京市房山区医务人员的吸烟状况和参与控烟的态度及控烟能力,为制定医务人员参与控烟工作提供措施依据。方法以询问和自填问卷相结合的方式对本区4所医院600多名医护人员进行调查,并对干预组实施一系列控烟干预措施,评价干预效果。结果经过干预,干预组医务人员在院内随意吸烟的现象较干预前下降了18．8％,在劝导患者戒烟和为吸烟者制定戒烟计划方面分别比基线高出14．9％和25．8％,也明显优于对照组（P〈0．01）;对烟草相关知识的认知程度较干预前和对照组明显提高（P〈0．01）。结论针对医务人员开展的控烟干预是可行的,以医务人员为切人点进行控烟健康教育能提高医务人员的控烟能力。     

北京市海淀区医务人员吸烟行为与控烟能力干预效果评价

[目的]评价医务人员吸烟行为与控烟能力干预效果,探讨提高医务人员控烟能力,降低其吸烟率的工作模武.[方法]用系统抽样方法选取项目组和对照组各3家医院的医务人员进行现场问卷调查.[结果]干预后干预组医务人员控烟知识、态度、行为均比对照组的有提高,尤其是控烟知识.干预组自身前后比较,干预后医务人员知晓戒烟方法的比例增加28,6%(x2=80.635, P=0.000),认为医院是无烟场所的比例增加5.6%(x2=4.976, P=0.026),能提醒患者戒烟的比例提高4.1%(x2=3.962, P=0.047),能制定戒烟计划的比例增加7.8%(x2=5.554, P=0.018).吸烟行为干预效果不明显.[结论]培训是提高医务人员控烟能力的有效途径.     

北京市海淀区医务人员吸烟状况及控烟知识、态度、行为现况调查

[目的]了解北京市海淀区医务人员吸烟和控烟能力现状,为开展医务人员戒烟活动,提高控烟服务能力提供科学依据。[方法]采用系统抽样方法,调查6家医院的医务人员。[结果]现吸烟率9.7%,男性吸烟率39.8%。吸烟者主要是临床一线的中年医生,且为中、高级职称的医院内业务骨干。43.3%的医务人员在吸烟区吸烟。71.2%的医务人员没有接受过戒烟方面的培训。大多数的医务人员对控烟态度积极。27.9%的医务人员能根据患者的吸烟情况为其制定戒烟计划。87.9%的医务人员提醒过吸烟的患者戒烟,但吸烟的医务人员提醒患者戒烟的比例低于从不吸烟的医务人员。[结论]开展控烟系列培训提高医务人员整体的控烟能力。运用行政干预与健康教育相结合的手段促使吸烟的医务人员戒烟。     

长沙市望月湖社区控烟效果的研究

目的了解社区居民在开展控烟干预前后对吸烟和戒烟的知识、态度、行为变化情况。方法对干预社区的20—60岁居民采用单纯随机抽样，两次共调查2068人。结果吸烟及被动吸烟危害健康的知晓率分别提高17．97％和21．01％，社区居民主动向医护人员寻求戒烟服务、看到朋友或家人吸烟时经常进行劝阻的比例明显提高。但项目实施前后，吸烟率分别为39．62％、38．96％，戒烟率分别为8．60％和8．30％，均无显变化。结论成人控烟难度大，控烟工作的重点应该是创造无吸烟环境，防止被动吸烟。因此，控烟工作应从小抓起，从拒吸第一支烟抓起。     

江苏省扬州市部分医务人员吸烟行为及控烟知识现状调查

目的对江苏省扬州市医务人员的吸烟行为和控烟知识现状进行调查,为今后在医务人员群体中实施控烟干预提供依据。方法采用问卷调查的方法,对扬州市4家医疗机构605名直接从事医务工作的人员进行问卷调查。结果医务人员人群总吸烟率为16.03%,现在吸烟率为11.57%;烟草危害的知晓率为73.61%,7种吸烟相关疾病的知晓率为71.00%,6种被动吸烟相关疾病的知晓率为77.60%;对医疗机构控烟认同率为83.63%;43.46%的医务人员获得过控烟方面的知识培训,能为病人制定戒烟计划的有1.69%;能对病人在门诊和病房提供健康教育的有31.40%。结论医务人员人群烟草相关知识掌握相对不足,应当进一步加强医务人员控烟知识和技能的健康教育和培训,改变其吸烟行为,同时也更好地推动社会控烟工作。     

青岛市部分医院医务人员吸烟行为与控烟能力干预效果评价

目的评价控烟干预对医务人员吸烟行为的影响效果,探讨提高医务人员控烟能力的方法,推进医院无烟环境建设。方法以参加无烟城市盖茨中国控烟项目的青岛市5家医院的医务人员为研究对象,经过1年的环境、政策、健康教育等控烟干预手段,评价医务人员吸烟行为和控烟能力干预效果。结果经过1年的干预,医务人员总体吸烟率下降,吸烟量降低;对吸烟和二手烟的认知有了改变;支持无烟政策,在诊疗过程中为就诊者提供烟草危害知识和戒烟服务能力提高。结论针对医务人员控烟的行为是积极可行的,对医务人员进行控烟健康教育措施效果显著,但在戒烟技巧、戒烟政策常态化方面应进一步提高和改善。     

安徽省泾县医务人员吸烟及相关知识调查结果分析

目的全面了解泾县医疗卫生机构医务人员吸烟相关知识、态度、行为。方法使用统一问卷,采取现场问答与自填问卷调查方法相结合对泾县18家医疗卫生机构594名医务人员进行问卷调查。结果泾县医务人员现在吸烟率为26．4％,57．7％的医务人员存在被动吸烟,与吸烟有关的知识知晓率存在较大差异。结论加强医务人员吸烟行为干预和与吸烟有关危害知识的健康教育,开展拒绝被动吸烟技能培训,提高医务人员戒烟自觉性。     

长沙市10家无烟医院创建效果评价

目的对长沙市10家医院开展控烟干预工作,评价控烟效果,为创建无烟医院提供依据。方法开展以政策制定、健康教育、氛围营造为主的控烟干预活动,干预前后采用问卷调查医务人员吸烟和被动吸烟相关知识、态度和行为的变化,评价干预效果。结果干预后,目标人群现在吸烟率由16.8%下降至13.7%,对于吸烟以及被动吸烟危害的认识也有所提高。医务人员更认为自身应在控烟工作中发挥表率作用,在日常工作中主动帮助患者戒烟。同时,在实际诊疗工作中主动询问病人吸烟习惯的医务人员比例也得到提高。结论无烟医院创建有利于提高医务人员对烟草及被动吸烟危害的认识,降低医务人员自身吸烟率以及促进其主动对患者进行控烟干预。无烟医院创建经验值得在其他行业进行推广。     

医务人员控烟干预效果评价

目的评价医务人员控烟干预效果。方法选取一、二级医院各2所,组成干预组、对照组,对干预组进行为期半年的控烟干预活动。采用自填问卷的方法,在干预前、后分别进行调查,评价干预效果。结果在院内随意吸烟行为有明显改进,吸烟态度有明显改变,戒烟知识知晓率提高,以上差异均有统计学意义;干预组吸烟率略有下降,但不具有统计学意义;部分与烟草有关的疾病的认知还有待继续提高。结论针对医务人员的控烟干预是可行的,其效果要继续巩固。     

Randomized controlled trial for smoking cessation among city office employees

To evaluate the effect of a smoking cessation program by health professionals, a randomized intervention study was carried out in the Omihachiman city office in 1993. Participants (n = 53), volunteers from current smokers in the city office, were randomly divided into intervention and control groups. The intervention group received intensive education for five months (i.e., the effect of smoking on health, the beneficial aspects of quitting smoking, how to stop smoking and how to deal with the withdrawal symptoms). Group lectures (two times) and individual counseling (three times) were used for health education. After five months, the control group was also given the same advice on smoking cessation. Comparison of smoking cessation rates between the two groups was performed at the end of the intervention period. Follow-up of all participants occurred at six and 12 months post intervention. After the five months of intervention, smoking cessation rate in the intervention group (19.2%) tended to be higher than that in the control group (7.4%), but was not significant (chi 2 = 1.62). Over all smoking cessation rates of all participants (n = 53) at the end of the 10 month intervention was 32.1% and at six months and 1 year after the end of the 10 month intervention were 24.5% and 13.2%, respectively. Comparison of participants who successfully stopped smoking and those who did not, it was revealed that younger age, lower expired air CO concentration (p < 0.01), and attitude for smoking cessation at the beginning were significantly related to smoking cessation. In our study, after five months, smoking cessation rate in the intervention group was about two times that of the control group, although the effectiveness of our smoking cessation program could not be validated due to small sample size. Taking into account the rate of smoking cessation after one year, We believe that programs by health professionals are effective for smoking cessation.     

Effectiveness of smoking-cessation intervention in all of the smokers at a worksite in Japan

In Japan, the prevalence of smoking among males and females was 56.1% and 14.2%, respectively, in 1997. Male smoking prevalence was exceedingly high as compared to those in other industrialized countries. We conducted a randomized controlled intervention study on smoking cessation for all smokers in a worksite regardless of their willingness to quit smoking. All of the male smokers in a radiator manufacturing factory (n=263) were randomly allocated to an intervention group (n=132) or a control group (n=131). Subjects in the intervention group received individual counseling by a doctor, and those who signed a Smoking Cessation Declaration underwent a five-month intervention. Subjects in the control group received equivalent delayed intervention for four months. The cessation rate after the original intervention was 12.9% (17/132) and 3.1% (4/131) in the intervention and control groups, respectively (p=0.003). Among those who once succeeded in quitting, 48.6% (18/37) maintained cessation at the long-term survey. Overall, the cessation rate was 8.4% (22/263) and the prevalence of smoking among males significantly decreased from 62.9 to 56.7% (p=0.038). As a conclusion, intervention in all smokers at a worksite regardless of their willingness to quit is effective and impacts the overall smoking rate.     

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。     

Effectiveness of a low-intensity intra-worksite intervention on smoking cessation in Japanese employees: a three-year intervention trial

To test the effectiveness of a low-intensity intervention program for smoking cessation targeting the worksite environment in employees who had a low readiness to quit, we conducted an intervention trial at six intervention and six control worksites in Japan. A total of 2,307 smokers at baseline who remained at their worksite throughout the three-year study period were analyzed (1,017 in intervention and 1,290 in control groups). The multi-component program at the worksites consisted of (1) presenting information on the harms of tobacco smoking and the benefits of cessation by posters, websites, and newsletters; (2) smoking cessation campaigns for smokers; (3) advice on designation of smoking areas; and (4) periodic site-visits of the designated smoking areas by an expert researcher. At baseline, the intervention and control groups each had high prevalence of immotive or precontemplation, that reflected low readiness to quit (71.5% and 73.2%, respectively). The smoking cessation rate, as not having smoked for the preceding six months or longer, assessed at 36 months after the baseline survey by a self-administered questionnaire was significantly higher in the intervention group than the control group (12.1%, vs. 9.4%, p=0.021). The intervention program still had a significant effect on the smoking cessation rate after multiple logistic regression analysis adjusted for sex, age, type of occupation, age of starting smoking, quit attempts in the past, number of cigarettes per day, and readiness to quit (odds ratio: 1.38, 95% confidence interval: 1.05-1.81, p=0.02). The cost per additional quitter due to the intervention was calculated to be Yen 70,080. These findings indicate that this program is effective and can be implemented in similar workplaces where the prevalence of smoking is high and smokers' readiness to cease smoking is low.     

A pilot study of telephone-based smoking cessation intervention in asbestos workers

Smoking markedly increases the risk of asbestos-related lung cancer. We conducted a randomized pilot trial of a telephone-based smoking cessation intervention in asbestos workers. Fifty-nine smokers were assigned to either a control or telephone-based smoking cessation treatment group and were followed-up at 6 months. Intent-to-treat analysis revealed a 16.7% quit rate at 6 months for the intervention group compared to 6.9% for the control group (P = 0.25). Treatment-received quit-rates were 33% for the intervention group and 6.9% for the control group (P = 0.05). The intervention group was twice as likely to use smoking cessation medicines and progressed further along the stage of change continuum compared with the control group. Incorporating telephone-based smoking cessation treatment into medical screening activities for asbestos workers is feasible and the intervention is effective in increasing quit rates at 6 months.     

组织改变理论在工厂戒烟干预中的应用研究

目的探索组织改变理论模型在中国工厂戒烟干预应用的可行性和效果。方法于2008～2009年对上海市两家工厂进行对照研究。对照组246人(男204,女42),平均年龄(34.7±13.2)岁,干预组233人(男203,女30),平均年龄(31.1±11.9)岁。将组织改变理论模型的4个阶段应用到干预组的戒烟干预中。分别在干预前和干预后,以问卷调查表的形式收集员工每日吸烟量、吸烟率、危害认知和戒烟意愿等方面的改变。在干预6个月后以戒烟者尿液中可的宁浓度的生物学检测判定是否成功戒烟。结果干预组的现在吸烟率由干预前的59.8%下降到干预后的39.1%(P<0.01),每日吸烟量由(15.0±8.6)支/天下降到(11.9±7.9)支/天(P<0.01)。对照组则无显著改变;干预组吸烟者中愿意接受同事戒烟帮助的比例由干预前的3.7%上升到干预后的15.6%(P<0.01),认为吸烟对健康有严重危害的比例也由干预前的36.5%上升到干预后的64.4%(P<0.05),对照组则均无显著改变(P>0.05);干预组吸烟者中打算在1个月内戒烟的比例由干预前的11.0%提高到干预后的41.5%(P<0.01),而对照组则无显著改变(8.5%vs9.5%);干预组和对照组6个月的戒烟成功率分别为24.6%和6.4%(P<0.01)。结论组织改变理论模型在中国工厂开展戒烟干预中的应用是可行的;该模型的应用对降低工人的吸烟率和每日吸烟量,提高吸烟者的戒烟意愿是显著的,6个月的戒烟成功率也显著提高。     

A randomized controlled trial of group intervention based on social cognitive theory for smoking cessation in China

BACKGROUND: New training programs need to be developed to help Chinese smokers achieve quitting. The objective of this study was to assess the effectiveness of a group smoking cessation intervention based on social cognitive theory among Chinese smokers. METHOD: A total of 225 smokers were eligible for the study and were randomly assigned to an intervention group (n=118) and a control group (n=107). The intervention group received the course soon after a baseline survey, whereas the control group received routine training in the first 6 months, and then took the same course. Effectiveness was evaluated at 6-month and 1-year follow-up from baseline. RESULTS: After 6 months, 40.5% (47/116) in the intervention group and 5.0% (5/101) in the control group quit smoking (absolute risk reduction: 35.5% [95% confidence interval (CI): 24.2-46.8%]). The 6-month continuous abstinence rate was 28.4% (33/116) in the intervention group and 3.0% (3/101) in the control group (absolute risk reduction 25.4% [95% CI: 15.6-35.2%]). At 1-year follow-up, the proportion of quitting and the 6-month abstinence rate in the intervention group were 35.8% and 22.0%, respectively. The factors associated with smoking cessation during the 6 month period were intervention (adjusted odds ratio [OR]=6.42 [95% CI: 2.46-13.28]), as well as anticipation of quitting (adjusted OR=1.46 [95% CI: 1.12-1.91]) and skill self-efficacy score in the baseline (adjusted OR=1.04 [95% CI: 1.01-1.07]). The same intervention was conducted in the control group after the 6-month study, in which a similar intervention effect was observed. CONCLUSION: A smoking cessation intervention based on social cognitive theory among Chinese smokers is highly effective.     

The impact of physicians' brief smoking cessation counseling: a MIRNET study

Although many family physicians may discuss smoking cessation with their patients, few do so consistently. A common belief among many physicians is that such efforts will not deter their patients from smoking. Others believe the time commitment required for a successful intervention is excessive. The present study addressed the above issues by examining the effect of a 3- to 5-minute unstructured physician discussion encouraging smoking cessation with family practice patients. Cigarette-smoking patients of two busy family practices in southeast Michigan were randomly assigned to either a control group receiving routine care or an intervention group receiving, in addition to routine care, smoking cessation counseling from their physician. A third comparison group was drawn from smokers in practices not involved in delivering the intervention. Two hundred thirty-eight patients from the intervention group, 178 from the control group, and 47 from the comparison group were followed up with a telephone interview at 6 months. Intervention group patients made significantly more quit attempts than did those in the control group (P less than .001), which was similar to the comparison group. At the 6-month follow-up, 8% of intervention group members, and 4% of both the comparison and control groups reportedly were abstinent from smoking. Among those contacted at the 1-year follow-up, the respective percentages abstinent were 8%, 3%, and 4%. Although these differences in quit rates were not statistically significant, the findings suggest that physicians can positively affect patient smoking cessation. This intervention was feasible in busy family practices, highlighting its generalizability and applicability to other family practice settings in the United States.     

柳州市医务人员吸烟与控烟知信行调查

目的了解医务人员吸烟与控烟知信行情况,为控烟干预措施提供依据。方法分层多级随机抽样方法,抽取市一、二、三级医院各1所,采用一对一调查方式,对所得数据进行统计分析。结果医务人员总吸烟率20.5%,现吸烟率19.3%;男性吸烟率42.7%,女性吸烟率1.6%。年龄组40～49岁组吸烟率最高为28.0%,最低为20～29岁组为10.2%;医技人员吸烟率47.2%;副高级以上职称吸烟率为47.6%。结论医务人员对吸烟危害健康认识不足,控烟知识了解不够。该市应加强戒烟控烟教育,提高其烟草危害相关知识水平,并进行戒烟方法的培训,引导其主动戒烟,从而带动其他吸烟人群戒烟。