吸烟对冠心病支架植入术患者预后的影响

目的:探讨吸烟对冠心病支架植入术患者预后的影响。方法:入选2006年8月～2010年8月在我院行冠脉支架植入术患者378例,术后随访两年,根据患者术后是否吸烟将其分为戒烟组(237例)和吸烟组(141例),比较吸烟对两组患者预后的影响。结果:随访两年后,与戒烟组比较,吸烟组患者心绞痛(13.1%比22.0%)、非致死性心梗(1.3%比4.9%)发生率明显升高(P<0.05);而两组患者在全因死亡率(2.9%比2.8%)、因心脏病再住院率(11.0%比8.5%)的差异无显著性(P>0.05)。结论:吸烟对冠心病支架植入术后患者有一定的影响,再发心绞痛及非致死性心肌梗死率显著升高。     

心血管疾病患者戒烟效果的影响因素

目的 分析心血管疾病患者戒烟效果的影响因素。 方法 心血管内科住院的吸烟患者在接受戒烟健康教育后随访观察12个月，按戒烟效果分为戒烟有效组（n = 156）和戒烟无效组（n = 188）, 采用病例对照研究方法分析戒烟效果的影响因素。 结果 单因素分析显示年龄>70岁、冠心病、高血压病和心功能不全患病率高及既往每日吸烟数量少（≤10 支/d）的人群戒烟有效率显著增高（均P<0.01）；独居及接触吸烟的患者戒烟有效率显著降低（均P<0.01）。多因素Logistic回归分析显示患有冠心病、心功能不全、独居、接触吸烟者及每日吸烟数量少均是戒烟效果的独立影响因素，患有冠心病，心功能不全和每日吸烟数量少能提高戒烟有效率，而独居和接触吸烟者降低戒烟有效率。 结论 患者患有严重疾病有利于提高戒烟有效率，但独居和接触吸烟者不利于提高戒烟有效率。     

住院吸烟患者的戒烟干预效果评价

目的本研究以住院吸烟患者为研究对象,探讨戒烟干预的效果。方法选择2010年12月—2012年11月呼吸科、心血管内科两科室的住院吸烟患者共240例,将其随机分为2组,对照组(简短戒烟建议)120例,干预组(强化戒烟干预)120例。进行统一问卷调查,采用面对面强化式戒烟心理辅导及简单口头忠告两种不同干预方式,并在出院后进行6个月内的电话随访,并跟踪戒烟状况和戒断症状,据自报的戒断情况,确定时点戒烟率、持续戒烟率,判断戒烟干预的效果。结果强化干预组出院后1个月、3个月、6个月的时点戒烟率以及6个月的持续戒烟率明显高于对照组,差异有统计学意义(P<0.05);且部分戒断症状如焦虑或紧张、体质量增加、渴望吸烟的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论对住院吸烟患者实施戒烟干预,尤其是在与吸烟密切相关性疾病的科室,可行且有效;强化戒烟干预较简单戒烟干预更有效。     

强化慢病管理门诊对冠心病患者预后的影响

目的:评估强化慢病管理门诊对冠心病患者的服药依从性,心血管事件再入院率,心功能评级的影响。方法:2012年1月2013年12月在成都医学院第一附属医院心血管内科就诊的180例明确诊断冠心病的患者,分为强化管理组和一般管理组(对照组)。强化管理组每2周通过规范化慢病管理门诊方式随访,每3个月定期检测,一般管理组通过每月门诊或电话随访。观察两组患者服药依从性、心血管事件再入院率,心功能评级(NYHA评级)。结果:随访2年后发现,强化管理组阿斯匹林/氯吡格雷(74%vs.54%,P<0.01)、他汀类药物(69%vs.46%,P<0.01)、ACEI/ARB(76%vs.46%,P<0.01)和β受体阻滞剂(63%vs.42%,P<0.05)的服药率均优于一般管理组;因心血管事件再入院率也较低(26%vs.42%,P<0.05)。结论:加强对冠心病患者的规范化管理,有助于提高患者服药依从性,减少患者心血管事件再入院率。     

强化门诊随访对心力衰竭患者预后及依从性的影响

目的 评估强化门诊随访对慢性心力衰竭(心衰)患者预后及依从性的影响.方法 回顾分析333例心衰患者门诊诊治情况,按其是否定期于心衰门诊随访,分为强化门诊随访组(随访组)和常规治疗组(常规组).调查患者预后、药物治疗情况、生活质量和医疗费用.结果 随访组患者死亡与再住院率联合终点显著低于常规组(42.59%比66.67%,P<0.05);随访组患者死亡显著低于常规组(1.85%比14.35%,P<0.05);血管紧张索转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂的处方率、达靶剂量率显著高于常规组(86.79%比40.54%,P<0.05;17.92%比8.65%,P<0.05);β受体阻滞剂处方率、达靶剂量率显著高于常规组(89.62%比46.49%,P<0.05;17.92%比1.62%,P<0.05).随访组患者生活质量较高(明尼苏达心衰生活质量问卷评分30.7比37.7,P<0.05),平均医疗费用节省3821.51元.结论 强化心衰门诊随访可以促进有循证医学证据的药物治疗,降低心衰患者的病死率和再入院率,改善生活质量并降低医疗费用.     

心脑血管病和糖尿病住院患者吸烟及戒烟状况调查及干预措施探讨

目的 调查因心脑血管病和糖尿病住院患者吸烟状况及其戒烟意愿,探讨医师戒烟干预措施及其效果.方法 对2011年2月至6月在北京同仁医院心内科、神经内科和内分泌科住院的1 237例患者进行吸烟和戒烟状况问卷调查,其中心血管病患者592例,脑血管患者291例,糖尿病患者354例.针对现吸烟患者(n =345)进行戒烟干预,并按随机原则分为常规干预组(n=172)和强化干预组(n=173).通过电话随访出院后6个月时的吸烟和戒烟状况.结果 心脑血管病和糖尿病住院患者总吸烟率为47.0％(582/1 237),现吸烟率为27.9％(345/1 237).经过住院期间对现吸烟患者进行戒烟干预,患者戒烟意愿向戒烟行动期转变.在6个月随访中,303例接受电话随访患者总戒烟率为30.0％,强化干预组戒烟率(45.8％)高于常规干预组(21.3％),P＜0.05.结论 心脑血管病和糖尿病住院患者吸烟率高,对烟草危害认知度较低.对住院患者采用强化干预措施有助于提高戒烟率.     

急性冠状动脉综合征患者吸烟现状及简单戒烟干预的临床效果评价

目的 了解急性冠状动脉综合征(ACS)并吸烟患者出院后6个月持续戒烟率、复吸率,评价简单干预的戒烟效果.方法 收集ACS并吸烟患者150例,分为简单干预组(87例)和常规治疗组(63例),随访6个月,比较两组患者2个月、6个月戒烟率、复吸率,应用logistic回归模型进行复吸相关因素分析.结果 ACS患者现吸烟率为31.14%,6个月持续戒烟率为64.6%,6个月复吸率为36.4%.简单干预组和常规治疗组6个月持续戒烟率和复吸率无差异.尼古丁依赖评分4分以上可作为复吸的预测指标.结论 ACS患者6个月持续戒烟率高于一般人群.给予简单戒烟干预不增加ACS患者戒烟成功率,需要强化干预.     

青年吸烟冠心病患者冠状动脉病变特点和控烟干预

目的 分析青年吸烟冠心病患者冠状动脉病变特点,并探讨人为干预对控烟的影响.方法 入选确诊为冠心病的青年患者160例(14～35岁),将吸烟患者118例和非吸烟患者42例均分为心理辅导组和对照组.通过冠状动脉造影分析患者的冠状动脉病变特点,并调查出院后3个月患者的吸烟情况.结果 与非吸烟患者比较,吸烟患者单支病变的比例较低(50.84%比66.67%,P＜0.01),急性冠状动脉综合征(75.42%比50.00%,P＜0.05)、双支病变(24.58%比19.05%,P＜0.05)、三支病变(11.86%比4.47%,P＜0.05)、冠状动脉瘤样扩张(12.71%比9.52%,P＜0.01)的比例和Gensini积分(61.94±40.35比45.08±28.97,P＜0.05)较高.在3个月的随访期中,吸烟患者心理辅导组的戒烟率高于对照组(61.76%比30.00%,P＜0.05);非吸烟患者心理辅导组的新发吸烟率低于对照组(0比5.00%,P＜0.05).结论 青年吸烟冠心病患者的冠状动脉病变程度重于非吸烟患者.人为干预有助于控烟.     

戒烟门诊患者烟草危害认知与戒烟效果评价

目的旨在了解为得到戒烟帮助的戒烟门诊患者对烟草危害知识掌握情况及不同掌握情况对其戒烟效果的影响。方法对来秦皇岛市第一医院戒烟门诊就诊的患者,通过面对面询问的方式收集数据,调查内容主要包括基本情况、职业、受教育程度、对烟草危害健康的认知情况,并进行为期3个月的戒烟效果随访。结果对吸烟会影响肺部健康,导致肺癌等疾病的认知正确率最高75.5%(612例)。吸烟危害性认知较低的主要包括以下几种常见疾病:脑卒中(33.5%,272例)、骨质疏松(35.6%,288例)、过早衰老(34.0%、276例);对二手烟危害,与吸烟危害认知基本一致,其中成人肺癌认知正确率最高(72.6%,589例),婴儿猝死综合征(41.6%,338例)的认知率体现了中国传统观念里对家庭和后代的关注,成人心脏病(18.2%,148例)、支气管炎(46.8%,380例)和哮喘(48.2%,391例)1 w、1个月及3个月随访时,戒烟组的吸烟危害认知得分均高于非吸烟组(t=2.8,P<0.01;t=3.1,P<0.01;t=8.8,P<0.01)。结论①戒烟门诊患者对烟草的危害有一定认识,但认识仍不全面;②吸烟危害认知度越高,对今后的戒烟效果越有帮助,因此,开展有效多样的吸烟危害宣教有重要意义。     

冠状动脉介入治疗患者戒烟状况和动机分析

目的调查冠状动脉介入(PCI)治疗患者吸烟和戒烟状态,分析患者戒烟动机。方法对280名目前正在冠心病随访门诊规律就诊的PCI治疗后患者进行问卷调查,内容包括性别、年龄、第一次行PCI治疗的时间、吸烟情况、戒烟和戒烟动机等相关问题。比较各组患者初次冠状动脉介入治疗的年龄。比较不同程度戒烟的患者的吸烟量、戒烟或减少吸烟动机的差异。结果吸烟组的初次冠状动脉介入治疗年龄(56.7±16.0)岁,不吸烟组初次冠状动脉介入治疗年龄(65.5±9.8)岁,t=-5.457,P=0.000。不吸烟组中被动吸烟者的初次冠状动脉介入治疗年龄为(61.8±10.3)岁,低于同组内非被动吸烟患者初次冠状动脉介入治疗年龄(66.4±9.5)岁,t=-2.278,P=0.024。到调查的时间为止,只有10%的患者仍维持原量吸烟,83.0%的患者在初次介入治疗出院后戒烟或减少吸烟。戒烟组(91例)每日吸烟量中位数为20(10,20)支,小于吸烟量减少组(26例)的每日吸烟量20(20,30)支,Mann-Whitney检验结果,Z=-2.734,P=0.006。患者戒烟或吸烟的动机多为几个,其中家人、朋友和医生的劝说和担心对心脏疾病产生进一步危害选择比率最高。结论吸烟患者初次冠状动脉介入治疗年龄明显低于非吸烟患者,绝大多数冠心病患者在初次介入治疗后戒烟或减少吸烟。医生劝说是最重要的戒烟或减少吸烟的动机之一。     

冠状动脉旁路移植术后患者吸烟及戒烟依从性影响因素调查

目的 探讨影响冠状动脉旁路移植术后患者吸烟及戒烟依从性的相关因素.方法 以问卷调查的方式,对在北京大学人民医院心脏中心接受冠状动脉旁路移植术,并于2008年10月至2009年1月期间在门诊复查的160例冠心病患者进行吸烟及戒烟依从性影响因素调查.将其中问卷填写完整的153例患者分为不吸烟组(72例)和吸烟组(81例),并进行统计分析.结果 不吸烟组对于吸烟危害他人健康认知的比例高于吸烟组(100%比91.4%,P=0.011),不吸烟组对于吸烟与慢性阻塞性肺疾病相关认知的比例也高于吸烟组(80.6%比60.5%,P=0.007),而吸烟组对于吸烟与缺血性心脏病相关认知的比例高于不吸烟组(61.7%比40.3%,P=0.008).吸烟组从朋友同事中获得吸烟及戒烟相关知识和从医护人员中获得吸烟及戒烟相关知识的比例均高于不吸烟组[分别为22.2%比8.3%(P=0.018)和55.6%比26.4%(P=0.000)].吸烟组中,已戒烟患者68例(84.0%),未戒烟患者13例(16.0%).戒烟患者的戒烟依从性比例及家庭成员对患者的戒烟支持比例均高于未戒烟患者[分别为82.4%比38.5%(P=0.001)和94.1%比61.5%(P=0.003)].未戒烟患者术后尼古丁依赖评分较术前显著减低(3.77±2.31比2.46±2.30,P=0.008).结论 冠状动脉旁路移植术后患者对吸烟与冠心病和其他疾病的关联性存在不同程度的认知缺乏.医护人员对患者的戒烟宣教和家庭成员的支持是促使患者成功戒烟的重要因素.

Abstract：

Objective To analyze the underlying factors related to smoking and cessation compliance in patients following coronary artery bypass graft surgery (CABG). Methods From October,2008 to January, 2009, a total of 160 CABG patients received questionnaires concerning smoking and smoking cessation compliance in Peking university people's hospital, 153 patients completed the questionnaires and were divided into non-smoking (72 patients) and smoking group (81 patients). Results Cognition was better in non-smokers than smokers on smoking-related health hazards ( 100% vs. 91.4%,P =0. 011 ) and on the relationship between smoking and chronic obstructive pulmonary diseases (80. 6%vs. 60. 5%, P =0. 007) while cognition was better in smokers than non-smokers on the relationship between smoking and ischemic heart disease (61.7% vs. 40. 3% ,P=0. 008). Compared with non-smoker,smokers acquired significantly more knowledge on smoking and smoking cessation from friends and colleagues (22.2% vs. 8.3%,P=0.018) and from medical professionals (55.6% vs. 26.4% ,P=0.000). In the smoking group, 68 patients quit smoking (84.0%), while the remaining 13 patients failed to quit smoking (16.0%) post CABG. The smoking cessation patients were superior to the smoker patients on smoking cessation compliance (82.4% vs. 38. 5%, P =0.001 ) and support from family members (94. 1% vs.61.5%, P =0. 003). The nicotine dependence scores of current smokers significantly declined after CABG (preoperative3.77±2.31 vs. postoperative 2.46 ±2.30, P=0. 008 ). Conclusions Cognition on the relationship between smoking and coronary heart disease as well as other diseases should be improved in patients underwent CABG. Medical staff and family members play an equal important role on improving the smoking cessation rate for patients post CABG.     

吸烟的冠心病患者戒烟现状及影响因素分析

目的 了解吸烟的冠心病患者对于吸烟问题的认识及戒烟状况,揭示戒烟及戒烟未成功的原因和影响因素,为更有效地帮助冠心病患者控烟提供参考.方法 对350例吸烟的冠心病患者进行问卷调查,包括性别、年龄、吸烟史等,采用分组分析、logistic回归分析等方法分析戒烟的影响因素.结果 350例吸烟的冠心病患者平均年龄(59.6±10.2)岁,男321例(占91.7%).57.1%(200/350)的患者已戒烟,42.9%(150/350)的患者目前仍在吸烟.将患者按年龄分两组,非老年组患者(≤65岁,n=239)戒烟率50.6%,显著低于老年组患者(>65岁,n=111)的71.2%(P<0.001).非老年组有戒烟意愿及尝试过戒烟的比例分别为70.3%和48.3%,均低于老年组的81.2%和59.4%(P<0.001).76例戒烟复吸者中,复吸最主要原因为缺乏自我控制能力,占76.3%.logistic回归分析,影响戒烟未成功的因素:年龄≤65岁(OR=2.336,P=0.004)、文化程度低(OR=1.310,P=0.028)、行经皮冠状动脉介入治疗术(OR=0.261,P<0.001)、行冠状动脉旁路移植术(OR=0.107,P=0.004)、家庭总收入>4000 元/月(OR=1.828,P=0.003).结论 吸烟的冠心病患者戒烟水平和意识仍有待提高;除现有的控烟政策外,应更加关注中青年、文化程度较低、未行经皮冠状动脉介入治疗及冠状动脉旁路移植术、家人有人吸烟、体质指数及家庭总收入越高的吸烟冠心病患者的控烟活动;在针对吸烟冠心病患者控烟活动的同时对其周围环境宣传控烟活动也是迫切需要的.

Abstract：

Objective To investigate the status quo of smoking cessation and analyze factors influencing smoking cessation in cigarette smoking patients with coronary artery disease(CAD).Method A total of 350 smoking patients with CAD was surveyed by questionnaire,logistic regression analysis was performed to analyze factors influencing smoking cessation.Results Incidence of smoking cessation was 57.1%(200/350)in this cohort.Patients were divided into two groups,the elderlv(>65 years old,n=111)and the young group(≤65 years old,n=239).The smoking cessation rate in the elderlv group is significantly higher than in the young group(71.2%vs.50.6%,P<0.001).Aged patients and patients with high cultural level are easier to give up smoking.Logistic analysis showed that age≤65 years old (OR=2.336,P=0.004),low cultural level(OR=1.310,P=0.028),PCI(OR=0.261.P<0.001).coronary artery bypass graft(OR=0.107,P=0.004),total family income>4000 RMB/month (OR=1.828,P=0.003)are risk factors for failed smoking cessation.There are 76 patients smoking again in current smokers,most due to lack of self-control(76.3%).Compared to the elderly group,there is a higher proportion of smoking again due to the need of daily communication and work in the young group.Conclusions We still need to raise the awareness of smoking cessation for smoking patients with CAD.Following factors should be focused for tobacco control in CAD patients:younger age,lower cuItural level,not treated with PCI or CABG,patients with smoking family members.higher body mass index and higher total family income.     

Predictors of smoking cessation in patients admitted for acute coronary heart disease.

BACKGROUND: Smoking cessation is probably the most important single action after a coronary event. In order to increase the effectiveness of smoking cessation programs, it is important to have knowledge of the predictors of smoking cessation. Further, it is unknown whether smoking cessation programs have impact on these predictors. METHODS: Data were obtained from a randomized controlled trial of smoking cessation intervention in 240 smokers aged less than 76 years admitted for myocardial infarction, unstable angina, or cardiac bypass surgery. Baseline characteristics were prospectively recorded. Smoking cessation was determined by self report and biochemical verification at 12 months follow-up. RESULTS: In multivariate logistic regression analysis, a high level of nicotine addiction, low level of self-confidence in quitting and having previous coronary heart disease were significant negative predictors of smoking cessation at 12 months follow-up. Having previous coronary heart disease and a diagnosis other than acute myocardial infarction as a reason for admission were important negative predictors of abstinence in the usual care group, in contrast to the intervention group, although this did not reach a level of significance in the subgroup interaction analyses. A high level of nicotine addiction was a strong negative predictor in both groups. CONCLUSION: A high level of nicotine addiction is an important negative predictor of smoking cessation, even within an individualized smoking cessation program. Smoking cessation intervention seems to be especially effective in patients with previous coronary heart disease and in patients with unstable angina or coronary artery bypass surgery, compared to usual care.     

Cessation in the use of tobacco – pharmacologic and non‐pharmacologic routines in patients

Introduction: Approximately one‐third of the adult population in industrial countries and 70% in several Asian countries are daily smokers. Tobacco is now regarded as the world's leading cause of death. Approximately two‐thirds of lifelong smokers eventually die because of smoking. Smoking cessation is the most effective action to reduce mortality in patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease. Objective: The aim of this study was to determine the effectiveness of smoking cessation programmes in patients with smoking‐related disorders. Methods: Medline was searched for studies of interventions for smoking cessation in patients. Results: In patients with cardiovascular diseases and COPD, smoking cessation programmes with behavioural support over several months significantly increase quit rates. The intensity of the programmes seems to be proportional to the effect. A long follow‐up period is probably the most important element in the programmes. Even the most intensive programmes are very cost‐effective in terms of cost per life‐year gained. Effective programmes can be delivered by personnel without special education in smoking cessation using simple intervention principles. Conclusions: In patients with smoking‐related disorders, smoking cessation interventions with several months of follow‐up are effective and easily applicable in clinical practice. Wider implementation of such programmes would be a cost‐effective way of saving lives. Please cite this paper as: Quist‐Paulsen P. Cessation in the use of tobacco – pharmacologic and non‐pharmacologic routines in patients. The Clinical Respiratory Journal 2008; 2: 4–10.     

纤溶酶原激活物抑制剂-1在冠状动脉疾病时表达的变化

目的：研究纤溶酶原激活物抑制剂（PAI）-1分子在吸烟患者中的表达以及与冠状动脉粥样硬化病变的关系。方法：入选冠心病患者98例,根据吸烟时间和吸烟支数分为：强吸烟组（45例）和弱吸烟组（53例）;又根据冠脉造影分为：单支病变组（56例）和多支病变组（42例）,比较各组血清PAI-1分子含量。结果：强吸烟组患者血清PAI-1含量明显高于弱吸烟组[（41．17±8．5）mol／L比（34．26±7．8）,mol／L,P〈0．055;多支病变组PAI-1含量明显高于单支病变组[（43．21±8．3）mol／L比（31.16±6．4）mol／L,P〈0．05]。结论：冠状动脉病变严重程度与纤溶酶原激活物抑制剂-1含量有关,吸烟可破坏机体的内环境平衡,对纤溶起到明显的抑制作用。     

戒烟门诊强化心理行为干预的临床戒烟效果

目的 探讨戒烟门诊应用伐尼克兰联合强化心理行为干预的临床戒烟效果以及分析戒烟成功预测指标.方法 将2009年3月至2010年9月复旦大学附属中山医院“吸烟及其相关疾病门诊”进行戒烟咨询和干预者作为研究对象,筛选合适对象,分为加强随访组和普通随访组,主要观察第9～12周持续戒断率,应用logistic回归模型进行戒烟成功预测指标分析.结果 戒烟门诊烟草依赖患者应用伐尼克兰联合强化干预治疗第9～12周持续总体戒断率为52.3％,加强随访组60.9％ (28/46),普通随访组46.2％ (30/65),主要不良反应为恶心(39.6％,44/111),睡眠差和梦境异常(17.1％,19/111),均可耐受,戒断症状少.戒烟准备程度和服药时间可作为戒烟成功预测指标.结论 伐尼克兰联合心理行为干预临床戒断率高,强化心理行为干预更明显增加成功率,是戒烟门诊很好的治疗方案,充分戒烟准备和规律足疗程服药能进一步提高戒烟成功率.     

Cost effectiveness of a smoking cessation program in patients admitted for coronary heart disease.

BACKGROUND: Smoking cessation is probably the most important action to reduce mortality after a coronary event. Smoking cessation programs are not widely implemented in patients with coronary heart disease, however, possibly because they are thought not to be worth their costs. Our objectives were to estimate the cost effectiveness of a smoking cessation program, and to compare it with other treatment modalities in cardiovascular medicine. METHODS: A cost-effectiveness analysis was performed on the basis of a recently conducted randomized smoking cessation intervention trial in patients admitted for coronary heart disease. The cost per life year gained by the smoking cessation program was derived from the resources necessary to implement the program, the number needed to treat to get one additional quitter from the program, and the years of life gained if quitting smoking. The cost effectiveness was estimated in a low-risk group (i.e. patients with stable coronary heart disease) and a high-risk group (i.e. patients after myocardial infarction or unstable angina), using survival data from previously published investigations, and with life-time extrapolation of the survival curves by survival function modeling. RESULTS: In a lifetime perspective, the incremental cost per year of life gained by the smoking cessation program was euro 280 and euro 110 in the low and high-risk group, respectively (2000 prices). These costs compare favorably to other treatment modalities in patients with coronary heart disease, being approximately 1/25 the cost of both statins in the low-risk group and angiotensin-converting enzyme inhibitors in the high-risk group. In a sensitivity analysis, the costs remained low in a wide range of assumptions. CONCLUSIONS: A nurse-led smoking cessation program with several months of intervention is very cost-effective compared with other treatment modalities in patients with coronary heart disease.     

男性医生吸烟现状调查及肺功能检测分析

目的 调查咸宁市男性医生的吸烟状况及控烟知识掌握情况,探讨吸烟对肺功能的影响.方法 采用自行设计的调查问卷于2013年6月对我市30家医院的男性医生进行吸烟状况调查及肺功能检测.结果 共发放问卷1200份,有效问卷1123份,有效回收率为93.6％（1123/1200）,男医生的吸烟率为31.0％,其中市属医院、区县医院、乡镇医院吸烟率分别为21.1％（80/380）、28.4％（101/356）和43.2％（167/387）,不同医院、年龄、文化程度、职称的医务人员吸烟率比较差异有统计学意义（P＜0.01）.医务人员对烟草所造成的心肺系统危害知晓率高,有72.1％的吸烟者尝试过戒烟或有戒烟计划,58.6％的医生在医院会劝阻患者吸烟.吸烟者的肺功能指标低于非吸烟者.结论 咸宁市男性医生吸烟率较高,吸烟者肺功能与非吸烟者比较有不同程度下降.